[Scoring system of late effects of radiations on normal tissues: the SOMA-LENT scale].
ABSTRACT Radiation tolerance of normal tissues remains the limiting factor for delivering tumoricidal dose. The late toxicity of normal tissues is the most critical element of an irradiation: somatic, functional and structural alterations occur during the actual treatment itself, but late effects manifest months to years after acute effects heal, and may progress with time. The optimal therapeutic ratio ultimately requires not only complete tumor clearance, but also minimal residual injury to surrounding vital normal tissues. The disparity between the intensity of acute and late effects and the inability to predict the eventual manifestations of late normal tissue injury has made radiation oncologists recognize the importance of careful patient follow-up. There is so far no uniform toxicity scoring system to compare several clinical studies in the absence of a "common toxicity language". This justifies the need to establish a precise evaluation system for the analysis of late effects of radiation on normal tissues. The SOMA/LENT scoring system results from an international collaboration. European Organization Treatment of Cancer (EORTC) and Radiation Therapy Oncology Group (RTOG) have created subcommittees with the aim of addressing the question of standardized toxic effects criteria. This effort appeared as a necessity to standardize and improve the data recording, to then describe and evaluate uniform toxicity at regular time intervals. The current proposed scale is not yet validated, and should be used cautiously.
- SourceAvailable from: Paul Brunault[Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE: Although depression is prevalent in long-term breast cancer survivors (LTBCS; ≥5 years since diagnosis), it is underdiagnosed and undertreated. A better understanding of factors associated with depression could improve depression screening, treatment, and prevention in this population. Our study aimed to assess the link between patient and doctor ratings of breast cosmetic outcomes, late radiotherapy toxicity, and depression in LTBCS. METHODS: In all, 214 patients recruited from the ARCOSEIN study were assessed for late radiotherapy toxicity (by using the LENT-SOMA scale) and patient and doctor ratings of breast cosmetic outcomes (mean = 6.7 years since the end of treatment). We reassessed 120 of these patients for depression (HAD) during a second wave of long-term assessment (mean = 8.1 years since the end of treatment). We used univariate analyses and polytomous logistic regression analyses to predict the HAD depression, which was defined as follows: normal, 0-7 points; and significant depression, ≥8 points (8-10 points, possible depression; ≥11 points, probable depression). RESULTS: The mean HAD depression score was 4.5 ± 3.6. 19. 2% of our population had significant depression, 6.7% with probable depression, and 12.5% with possible depression. Significant depression was not associated with late radiotherapy toxicity or initial cancer-related variables. Patients with probable depression reported worse cosmetic outcomes than nondepressed patients in terms of perceived breast largeness (p = 0.04), breast deformation (p = 0.02), and changes in skin pigmentation (p = 0.03). CONCLUSIONS: In LTBCS, depression seems to be more strongly associated with changes in some patients' perceived breast cosmetic outcome than late treatment toxicity or initial cancer-related variables. Copyright © 2012 John Wiley & Sons, Ltd.Psycho-Oncology 02/2012; · 3.51 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To improve a questionnaire used to collect patient-reported outcomes from patients with early stage prostate cancer treated with brachytherapy. A secondary aim was to adapt the Late Effects of Normal Tissue (LENT) subjective toxicity questionnaire for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data, the current preferred platform for assessing radiation toxicity. Three hundred and seventy-seven patients were treated with permanent iodine-125 seed implant brachytherapy for early prostate cancer. Toxicity data were collected before and at nine time points post-treatment (0-36 months). Compliance rates for patients completing individual items and item-subsection correlation coefficients were calculated. A factor analysis was carried out to analyse responses to the questionnaire and identify less informative questions, which could be removed. Cronbach's α coefficient was used to measure reliability. Two thousand one hundred and eighty-eight questionnaires were analysed. There was poor compliance for questions specifically relating to operations and bowel medication. We found that the division of the questionnaire into subsections based on anatomical site was reasonable and that certain items could be safely removed. The high mean value for Cronbach's α across all questionnaires (0.752; 95% CI: 0.726-0.779) indicated that the questionnaire was reliable. Fifteen of the 44 questions were removed from the original questionnaires. Questions on urinary incontinence severity, management of urinary and bowel incontinence, effects of reduced flow of urine and the effects of symptoms on activity of daily living and change in sexual function were required to adapt the LENT subjective questionnaire for use to collect CTCAE data. A questionnaire, validated over 6 years to collect LENT subjective data were adapted and is a reliable approach for collecting CTCAE data after prostate brachytherapy.Radiotherapy and Oncology 10/2010; 97(1):136-42. · 4.52 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Le but de cet article est de décrire les effets de la radiothérapie pelvienne sur la sphère gynécologique à l’exclusion des ovaires. Sont ainsi décrites les conséquences immédiates et tardives sur la vulve, le vagin et l’utérus. Les mesures préventives et les stratégies de prise en charge sont discutées. Par ailleurs, ce papier insiste sur l’importance d’une description précise des lésions et sur l’intérêt des échelles standardisées comme le glossaire et l’échelle SOMA-LENT (Subjective-Objective-Management-Analytic-Late Effects of Normal Tissues) dans l’évaluation des séquelles fonctionnelles gynécologiques de la radiothérapie. The purpose of this paper is to review the effects of radiotherapy on the female reproductive tract excluding the ovarian impact. Immediate and late effects on the vulva, vagina, cervix and uterus are described. Preventive and management strategies are discussed. In addition, this paper highlights the importance of using validated tools such as the French and Italian glossary and SOMA-LENT scales to assess more precisely the late toxicity of radiotherapy on the genital tract. Mots clésRadiothérapie pelvienne-Échelle SOMA-LENT KeywordsRadiotherapy-SOMA-LENT scalePelvi-périnéologie 01/2010; 5(2):121-131. · 0.04 Impact Factor