Mao MH, Zhang J, Zhang JG, et al.
Brachytherapy. Date of publication 2017 Jan 1;volume 16(4):877-883.
1. Brachytherapy. 2017 Jul - Aug;16(4):877-883. doi: 10.1016/j.brachy.2017.02.011.
Epub 2017 May 8.
Comparing the RTOG/EORTC and LENT-SOMA scoring systems for the evaluation of late
skin toxicity after 125I seed brachytherapy for parotid gland cancer.
Mao MH(1), Zhang J(2), Zhang JG(2).
Author information:
(1)Department of Head and Neck Oncology, Capital Medical University School of
Stomatology, Beijing, PR China.
(2)Department of Oral and Maxillofacial Surgery, Peking University School and
Hospital of Stomatology, Beijing, PR China.
Erratum in
Brachytherapy. 2018 Jan - Feb;17 (1):250.
PURPOSE: The Radiation Therapy Oncology Group (RTOG) and Late Effects Normal
Tissue Task Force-Subjective, Objective, Management and Analytic (LENT-SOMA)
scoring systems were compared for grading late skin effects after iodine-125 seed
brachytherapy in parotid gland cancer patients.
METHODS AND MATERIALS: A total of 109 patients diagnosed with parotid gland
carcinoma were treated postoperatively with iodine-125 seed brachytherapy at a
dose of 100-120 Gy. After 6-24 months of followup, telangiectasia, skin
pigmentation, atrophy, fibrosis, and ulceration were scored according to both
RTOG and LENT-SOMA scale criteria. The strength of correlation between the scores
and the interobserver variability were calculated.
RESULTS: Of 109 patients, 22.9% had telangiectasia; 78.9%, pigmentation; 28.4%,
fibrosis; 4.6%, edema; 0.9%, ulceration; 37.6%, retraction and/or atrophy; 22.9%,
sensation change; and 11%, scaliness and/or roughness. Compared with RTOG,
LENT-SOMA criteria resulted in the upgrading of pigmentation in 17% of cases, the
downgrading of all instances of telangiectasia and the downgrading of one
instance of Grade 4 ulceration to Grade 3. Between the two scales, fibrosis and
atrophy correlated well (Spearman ρ, 0.992, 0.986). An additional 229 side
effects were observed using LENT-SOMA criteria.
CONCLUSIONS: The LENT-SOMA scale was more accurate than the RTOG scale for the
evaluation of late skin and subcutaneous toxicity. The downgrading of
telangiectasia and upgrading of pigmentation with the LENT-SOMA scale reflected
the patients' conditions better than the scores obtained with the RTOG scale. The
assessment of fibrosis and atrophy correlated well between the two scales. The
use of the sum of the individual scores of the LENT-SOMA is therefore advocated.
The addition of decreased sweating and the removal of the alopecia (scalp) metric
should be considered to standardize the reporting of late radiation morbidity.
Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All
rights reserved.
DOI: 10.1016/j.brachy.2017.02.011
PMID: 28495444
