SOMA-LENT Scoring of Complications Involving Mature Bone Following Cancer Therapy

Description

The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a patient with complications involving mature bone following radiation and chemotherapy.

NOTE: This does not include injury to the mandible (handled above under oral disorders.

Subjective measures:

(1) pain

(2) function

(3) joint movement

Objective measures:

(1) fracture

(2) mucosa and soft tissue

(3) skin over bone

(4) joint movement

Management measures:

(1) pain

(2) function

(3) joint movement

Analytic studies:

(1) imaging density: assessment for osteosclerosis and osteoporosis

(2) X-ray: assessment of bone and joint integrity (including linear fracture and displaced fracture)

(3) arthography: assessment of joint integrity

(4) arthroscopy: evaluation for joint abnormalities

If no toxicity is present, then the 0 points are assigned.

If a toxicity is present, then the grade indicates the number of points to assign.

	Grade 1	Grade 2	Grade 3	Grade 4
pain	occasional and minimal	intermittent and tolerable	persistent and intense	refractory and excruciating
function	interferes with athletic recreation	interferes with work	interferes with daily activity	complete lack of function
joint movement	stiffness interferes with athletic recreation	stiffness interferes with work	stiffness interferes with daily activity	complete fixation, necrosis
fracture	NA	NA	partial thickness	full thickness
mucosa and soft tissue	NA	NA	sequestration	NA
skin over bone	erythema	ulcer	sinus	fistula
joint movement	<= 10% decrease	10.1 – 30% decrease	30.1 - 80% decrease	> 80% decrease
management of pain	occasional non-narcotic	regular non-narcotic	regular narcotic	surgical intervention
management of function	occasional physiotherapy	intermittent physiotherapy	persistent physiotherapy or medical intervention	surgical intervention
management of joint movement	occasional physiotherapy	intermittent physiotherapy	corrective surgery	NA

total score =

= SUM(points for all 10 items)

LENT score =

= (total score) / 10

Interpretation:

• maximum total score: 38

• minimum LENT score: 0

• maximum LENT score: 3.8

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SOMA-LENT Scoring of Complications Involving Mature Bone Following Cancer Therapy

Description

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