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Carton E, Blas AM, Perret C, Le Bihan M. Effectiveness of increasing the scalp cooling duration to prevent alopecia during adjuvant chemotherapy for breast cancer: a randomized pilot study. Support Care Cancer 2024; 32:410. [PMID: 38839667 PMCID: PMC11153286 DOI: 10.1007/s00520-024-08579-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Alopecia is a common side-effect of chemotherapy and can be extremely distressing to patients. Scalp cooling can be used to reduce hair loss, but the optimal duration of cooling remains unclear. Our aim was to determine whether increasing the duration of scalp cooling improves hair preservation. METHODS Patients with HER2-negative, non-metastatic, breast cancer received scalp cooling during adjuvant chemotherapy: three cycles of epirubicin/cyclophosphamide (EC) followed by three cycles of paclitaxel. The patients were randomly assigned to two groups. Group A (n=18) wore a Paxman cooling cap during each infusion and for 30 min post-infusion while Group B (n=19) wore the cap from 30 min before to 2 h after each infusion. All patients were asked to complete a questionnaire recording hair loss/regrowth, adverse events, and quality of life. Success of treatment was defined as <50% hair loss. RESULTS The success rates after each of the three cycles did not differ significantly between the two groups (EC: Group A: 40%, Group B: 44%; paclitaxel: Group A: 50%, Group B: 36%; p>0.05). Hair regrowth was significantly higher in Group B at the 8-week follow-up, but not at the 6-month follow-up. Head discomfort affected more patients in Group B than in Group A during the first session (94% vs. 62%, respectively; p=0.039). CONCLUSION Long duration scalp cooling during chemotherapy might increase patients' discomfort and does not appear to improve hair preservation.
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Affiliation(s)
- Edith Carton
- CHP Saint Grégoire, ICRB, Oncologie-Radiothérapie - boulevard de la Boutière, 35760, Saint Grégoire, France
| | - Anne Mercier Blas
- CHP Saint Grégoire, ICRB, Oncologie-Radiothérapie - boulevard de la Boutière, 35760, Saint Grégoire, France
| | - Clément Perret
- CHP Saint Grégoire, ICRB, Oncologie-Radiothérapie - boulevard de la Boutière, 35760, Saint Grégoire, France
| | - Marcelle Le Bihan
- Direction des Soins Territoire Bretagne, Vivalto Santé, 9 boulevard de la Boutière, 35760, Saint Grégoire, France.
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Mekha M, Joshi A, Maniar V, Maheshwari U, Joshi K, Kalaskar P, Sheth S, Kendre P, Morzaria D, Korgavkar R, Pethe C, Dhande S. The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study. Indian J Dermatol 2024; 69:16-23. [PMID: 38572038 PMCID: PMC10986862 DOI: 10.4103/ijd.ijd_345_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Aim Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients. Materials and Methods This is a multi-centre, retrospective-observational study including patients registered from 1st March, 2019 to 30th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy. Results A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR: 44-62 years). The prevention of alopecia (grade 0 and grade I) was seen in 81%, while more than 50% hair loss (grade 2) was seen in 16.48% after completion of treatment. The univariate analysis results showed that CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04-6.958; P = 0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295-30.787; P = 0.001). The incidence of grade 2 (>50% hair loss) alopecia was 81.3% in patients <6 weeks and was 18.8% at >6 weeks of start of chemotherapy (P < 0.0001). No adverse events were reported in 71.4% of patients, and the most common adverse event was headache (18.7%). Conclusion PSCS is an effective and well-tolerated treatment modality for preventing CIA among breast cancer patients undergoing chemotherapy.
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Affiliation(s)
- Mangesh Mekha
- From the Department of Medical Oncology, Mumbai Oncocare Centre, Pune, India
| | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Vashishth Maniar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Udip Maheshwari
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Kshitij Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pritam Kalaskar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Smit Sheth
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pradip Kendre
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Disha Morzaria
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | - Reshma Korgavkar
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | | | - Sonal Dhande
- Department of Medical Oncology, Mumbai Oncocare Centre, Nashik, India
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3
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Michel A, Lee RT, Salehi E, Accordino MK. Improving Quality of Life During Chemotherapy: Cannabinoids, Cryotherapy, and Scalp Cooling. Am Soc Clin Oncol Educ Book 2023; 43:e390428. [PMID: 37267515 DOI: 10.1200/edbk_390428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There have been significant advances in the treatment of cancer in the past decade. However, patients continue to suffer from significant side effects of antineoplastic agents that greatly affect their quality of life (QOL), including chemotherapy-induced nausea and vomiting (CINV), chemotherapy-induced peripheral neuropathy (CIPN), and chemotherapy-induced alopecia (CIA). This review aims to provide an updated overview of emerging strategies for the management and prevention of these immediate and long-lasting side effects. The use of integrative medicine including cannabis continues to evolve in the realm of CINV and cancer-related anorexia. Although no pharmaceutical agent has been approved for the prevention of CIPN, cryotherapy, compression therapy and, more recently, cryocompression therapy have shown benefit in small trials, but there are concerns with tolerability especially related to cryotherapy. More data are necessary to determine an effective and tolerable option to prevent CIPN in large, randomized studies. Scalp cooling (SC), which has a similar mechanism to cryotherapy and compression therapy for CIPN prevention, has proven to be an effective and tolerable approach in randomized studies and has significantly limited CIA, an entity that definitively affects the QOL of patients living with cancer. Taken together, cannabis, cryotherapy, compression and cryocompression therapy, and SC all strive to improve the QOL of patients living with cancer by minimizing the side effects of chemotherapeutic agents.
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Affiliation(s)
- Alissa Michel
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | | | | | - Melissa K Accordino
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
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4
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Wang S, Yang T, Shen A, Qiang W, Zhao Z, Zhang F. The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer 2021; 29:6943-6956. [PMID: 33847828 DOI: 10.1007/s00520-021-06188-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/28/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically assess the efficacy and side effects of scalp cooling in patients with breast cancer. METHODS A systematic literature search was conducted in October 2020 across Cochrane Library, PubMed, Embase, CINAHL, Web of Science, Scopus, and four Chinese databases (CNKI, Wanfang, SinoMed, and VIP database). Our review included all randomized controlled trials, cohort studies, and cross-sectional studies. Two authors independently searched databases, screened studies, extracted data, and evaluated each included study's methodological quality and risk bias. Meta-analysis was performed using Stata 15.1 software package and Revman 5.3 software, with estimates of scalp cooling effect and its side effects from pooled using a random-effects model. This study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020216224). RESULTS In total, 755 articles were screened and data from 27 studies involving 2202 participants were used in the meta-analysis. Studies meeting inclusion and exclusion criteria were three randomized clinical trials, 12 cohort studies, and 12 cross-sectional studies. The effectiveness rate of using a scalp cooling device to protect hair was 61% (95% CI: 55 to 67%, I2 = 88%, P = 0.000). However, scalp cooling therapy's side effects are not be ignored, such as headache, dizziness, scalp pain, neck pain, feeling cold, heaviness of the head, skin rash, nausea, and overtightened strap. CONCLUSIONS This review shows that scalp cooling devices can significantly improve the patients with breast cancer chemotherapy-induced alopecia, but the implications of its side effects provide guide for the implementation of this technology.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Aomei Shen
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
| | - Zihan Zhao
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fangyuan Zhang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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Dilawari A, Gallagher C, Alintah P, Chitalia A, Tiwari S, Paxman R, Adams-Campbell L, Dash C. Does Scalp Cooling Have the Same Efficacy in Black Patients Receiving Chemotherapy for Breast Cancer? Oncologist 2021; 26:292-e548. [PMID: 33512741 DOI: 10.1002/onco.13690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Indexed: 11/11/2022] Open
Abstract
LESSONS LEARNED Despite U.S. Food and Drug Administration approval to reduce alopecia, data on efficacy of scalp cooling in Black patients with cancer are limited by lack of minority representation in prior clinical trials. Scalp cooling devices may have less efficacy in Black patients; additional studies are required to explore the possible causes for this, including hair texture and cap design. BACKGROUND The Paxman scalp cooling (SC) device is U.S. Food and Drug Administration (FDA)-approved for prevention of chemotherapy-induced alopecia. Studies report 50%-80% success rates and high patient satisfaction, yet there have been no studies of SC in Black patients. We conducted a phase II feasibility study of Paxman SC with a planned enrollment of 30 Black patients receiving chemotherapy for stage I-III breast cancer. METHODS Black patients who planned to receive at least four cycles of chemotherapy with non-anthracycline (NAC) or anthracycline (AC) regimens were eligible. Alopecia was assessed by trained oncology providers using the modified Dean scale (MDS) prior to each chemotherapy session. Distress related to alopecia was measured by the Chemotherapy Alopecia Distress Scale (CADS). RESULTS Fifteen patients enrolled in the intervention before the study was closed early because of lack of efficacy. Median MDS and CADS increased after SC, suggesting increased hair loss (p < .001) and alopecia distress (p = .04). Only one participant was successful in preventing significant hair loss; the majority stopped SC before chemotherapy completion because of grade 3 alopecia (>50% hair loss). CONCLUSION SC may not be efficacious in preventing alopecia in Black women. Differences in hair thickness, hair volume, and limitations of cooling cap design are possible contributing factors.
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Affiliation(s)
- Asma Dilawari
- MedStar Washington Hospital Center, Washington Cancer Institute, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Christopher Gallagher
- MedStar Washington Hospital Center, Washington Cancer Institute, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Princess Alintah
- MedStar Health Research Institute, Washington Cancer Institute, Washington, DC, USA
| | - Ami Chitalia
- MedStar Washington Hospital Center, Washington Cancer Institute, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Shruti Tiwari
- MedStar Washington Hospital Center, Washington Cancer Institute, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - Lucile Adams-Campbell
- Georgetown University, Office of Minority Health and Cancer Prevention and Control, Washington, DC, USA
| | - Chiranjeev Dash
- Georgetown University, Office of Minority Health and Cancer Prevention and Control, Washington, DC, USA
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Coolbrandt A, T'Jonck A, Blauwens K, Dejaeger E, Neven P, Punie K, Vancoille K, Wildiers H. Scalp cooling in breast cancer patients treated with docetaxel-cyclophosphamide: patient- and nurse-reported results. Breast Cancer Res Treat 2021; 186:715-722. [PMID: 33452953 DOI: 10.1007/s10549-020-06063-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Recent evidence supports the efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer treatments. However, efficacy largely varies between treatment regimens. The aim of this study was to explore the patient- and nurse-reported results of scalp cooling in terms of hair loss and need for a wig/head cover in patients with breast cancer treated with 3-weekly docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2. METHODS We studied nurse-reported efficacy as noted in the electronic patient files of 85 patients treated with docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2 between 1/1/2017 and 1/1/2020. Sixty-nine of them also self-reported on their scalp cooling results up to one year after adjuvant chemotherapy in a retrospective way. RESULTS Nurse- and patient-reported data showed that scalp cooling was successful (i.e., hair loss < 50%) in 47.1 and 44.9% of patients, respectively, and 55% of patients were (very) satisfied with the result of scalp cooling. Scalp cooling was perceived as (very) uncomfortable in 36.2% of patients. Regarding hair status one year after treatment, 47 patients (55.3%) reported no changes compared to their hair status before treatment. CONCLUSIONS Scalp cooling is successful in preventing severe chemotherapy-induced alopecia in almost half of the patients with breast cancer treated with docetaxel 75 mg/m2- cyclophosphamide 600 mg/m2. Better understanding of the success rate of scalp cooling enables correct patient information and decision-making support.
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Affiliation(s)
- A Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - A T'Jonck
- Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - K Blauwens
- Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - E Dejaeger
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - P Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Punie
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Vancoille
- Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - H Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
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7
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Silva GDB, Ciccolini K, Donati A, Hurk CVD. Scalp cooling to prevent chemotherapy-induced alopecia. An Bras Dermatol 2020; 95:631-637. [PMID: 32622629 PMCID: PMC7563013 DOI: 10.1016/j.abd.2020.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/20/2020] [Indexed: 02/07/2023] Open
Abstract
Chemotherapy-induced alopecia causes an important impact on cancer patients and its risk of persistence is currently a considerable issue in cancer survivors. Of the various interventions proposed for the prevention of chemotherapy-induced alopecia, scalp cooling has emerged as an effective and safe strategy. This paper aims to provide an overview on scalp cooling and chemotherapy-induced alopecia prevention.
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Affiliation(s)
| | - Kathryn Ciccolini
- Department of Hematology/Oncology, Mount Sinai Hospital, New York, NY, United States of America
| | - Aline Donati
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| | - Corina van den Hurk
- R & D Department, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
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8
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Bajpai J, Kagwade S, Chandrasekharan A, Dandekar S, Kanan S, Kembhavi Y, Ghosh J, Banavali SD, Gupta S. "Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia". Breast 2019; 49:187-193. [PMID: 31865282 PMCID: PMC7375683 DOI: 10.1016/j.breast.2019.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/04/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022] Open
Abstract
Background Randomized controlled trials (RCT) of scalp cooling (SC) to prevent chemotherapy induced alopecia (CIA) did not evaluate its effect on hair regrowth (HR) and was conducted in a predominantly taxane (T) treated population. We conducted an RCT of SC in a setting of anthracycline (A) and taxane chemotherapy (CT) and assessed its effect on CIA and HR. Methods Non-metastatic breast cancer women undergoing (neo) adjuvant CT were randomized to receive SC using the Paxman scalp cooling system during every cycle of CT, or no SC. The primary end point (PEP) was successful hair preservation (HP) assessed clinically and by review of photographs after CT. HR was assessed at 6 and 12 weeks. Results 51 patients were randomized to SC (34) or control arm (17) in a 2:1 ratio. Twenty-five (49%) patients received A followed by T and the two arms were balanced with respect to this factor. HP rate was significantly higher in SC arm compared to control arm (56.3% vs 0%, P = 0.000004). HR was higher in SC arm compared to control at 6 weeks (89% vs 12%; P < 0.001) and 12 weeks (100% vs 59%, P = 0.0003). Loss of hair at PEP evaluation, which was a quality of life measure, was significantly lower in SC versus control arm (45% vs 82%, P = 0.016). There were no grade 3–4 cold related adverse effects. Conclusions Women with breast cancer receiving A or T chemotherapy receiving SC were significantly more likely to have less than 50% hair loss after CT, superior hair regrowth and improvement in patient reported outcomes, with acceptable tolerance. It merits wider usage.
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Affiliation(s)
- J Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
| | - S Kagwade
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - A Chandrasekharan
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Dandekar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Kanan
- Statistician Department, Tata Memorial Hospital, Mumbai, India
| | - Y Kembhavi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - J Ghosh
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S D Banavali
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
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Bitto FF, König A, Phan-Brehm T, Vallbracht T, Koch JG, Schinköthe T, Wolfgarten M, Mahner S, Harbeck N, Würstlein R. EVA-Scalp: Evaluation of Patient Satisfaction with a Scalp Cooling Device to Prevent Chemotherapy-Induced Alopecia in Breast Cancer Patients. Breast Care (Basel) 2019; 15:171-177. [PMID: 32398986 DOI: 10.1159/000501393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/06/2019] [Indexed: 01/01/2023] Open
Abstract
Purpose Scalp cooling (SC) offers a chance to reduce hair loss (HL), but patient satisfaction, the effect on well-being, as well as patient selection criteria have not been sufficiently assessed yet. Methods In the EVAScalp trial, SC was offered to 70 breast cancer patients who received chemotherapy between November 2015 and September 2018. For SC, the Paxman-Orbis-II System was used. Satisfaction was measured by a questionnaire evaluating the level of depression with the WHO-5 well-being index (WHO-5) plus questions addressing the patient's experiences and side effects using the SC device. To evaluate efficacy, documentation by photo, by a physician, and by an HL-diary was conducted. Results Regarding efficacy, a significant difference between chemotherapy regimens is seen. Anthracycline-based therapies led to a stop of SC in 71% of the patients, whereas taxane-based therapies without anthracyclines were associated with a high acceptance of SC, and 88% of patients with paclitaxel-based therapies continued SC throughout their chemotherapy. Overall, only 7.69% of the patients stopped because of side effects. As an indicator for quality of life, WHO-5 was higher (65.8%) in patients with successful SC compared to in patients who stopped SC because of HL or side effects (only 53.0%). The majority of patients (82.22%) with successful SC would recommend SC to other patients. Conclusions Patients tolerated SC as long as HL was successfully prevented. The well-being of patients with successful SC was significantly higher than that of patients who stopped SC prematurely. In general, SC is a promising approach and improves patient well-being, but there are still limitations to its utility depending on the chemotherapy regimen used.
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Affiliation(s)
- Franz-Ferdinand Bitto
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Alexander König
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Thuy Phan-Brehm
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Thomas Vallbracht
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Julian Gregor Koch
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Timo Schinköthe
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | | | - Sven Mahner
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
| | - Rachel Würstlein
- Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
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Haslam IS, Smart E. Chemotherapy-Induced Hair Loss: The Use of Biomarkers for Predicting Alopecic Severity and Treatment Efficacy. Biomark Insights 2019; 14:1177271919842180. [PMID: 31037027 PMCID: PMC6475836 DOI: 10.1177/1177271919842180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/08/2019] [Indexed: 01/08/2023] Open
Abstract
Damage to hair follicles following exposure to toxic chemotherapeutics can cause substantial hair loss, commonly known as chemotherapy-induced alopecia (CIA). Preventive therapies remain limited; however, recent advances in the use of scalp cooling technologies have proved successful in preventing or reducing hair loss in some patients. Further improvements in scalp cooling efficacy and/or development of novel treatments to prevent chemotherapy-induced hair loss are required. To achieve this, post-chemotherapy assessment of hair follicle damage markers, with and without scalp cooling, would provide invaluable mechanistic and prognostic information. At present, the availability of such data is extremely limited. This article describes the potential utility of a combination of biomarkers in assessing drug-induced alopecia and the protective potential of existing or new treatments. A greater understanding of the precise mechanisms of anti-CIA therapies through biomarker analysis would enhance the rationale, use, and development of such treatments.
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Affiliation(s)
- Iain S Haslam
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Eleanor Smart
- Centre for Dermatology Research, University of Manchester, Manchester, UK
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