The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a male with complications following radiation and chemotherapy that affect the hypothalamic-pituitary-testicular axis.
Subjective measures:
(1) libido
Objective measures:
(1) fertility
(2) libido
Management measures:
(1) libido
Analytic studies:
(1) FSH, LH: assessment of hypothalamic-pituitary-testes axis integrity
(2) serum testosterone
(3) stimulated FSH and LH: assessment of testes responsiveness and integrity of the hypothalamic-pituitary-testes axis
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.
|
SOM |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
libido |
occasionally suppressed |
intermittently suppressed |
persistently suppressed |
"refractory and excruciating" |
|
fertility |
NA |
NA |
NA |
impotent |
|
libido |
occasional loss |
intermittent loss |
persistent loss |
NA |
|
management of libido |
NA |
hormone replacement |
NA |
NA |
where:
• "Refractory & excruciating" is listed as Grade 4 for libido. This may be an error (not that refractory loss of libido would not be excruciating), since this is the pattern of terms used for pain. I will use "NA" in the spreadsheet.
total score =
= SUM(points for all 4 items)
LENT score =
= (total score) / 4
|
Analytical |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
FSH and LH |
normal or borderline decrease |
decreased |
NA |
NA |
|
testosterone |
normal or borderline decrease |
decreased |
NA |
NA |
Interpretation:
• maximum total score: 12 (assuming no Grade 4 subjective value for libido)
• minimum LENT score: 0
• maximum LENT score: 3.00
Specialty: Hematology Oncology, Endocrinology
