Radiation Induced Alopecia: An Under-Appreciated Side Effect of Whole Brain Radiotherapy and Strategies to Ameliorate it

Ahmad, Irfan; Sardana, Kabir; Chufal, Kundan Singh; Bhatt, Chandi Prasad

doi:10.4172/2155-9619.s9-002

Cited by 3 publications

(5 citation statements)

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“…7,8,21,[23][24][25][26][27][28] Hair follicle radiosensitivity is also dependent on hair cycle stage: anagen matrix cells are more radiosensitive than telogen matrix cells owing to relative differences in proliferation rates. 8,29 While the dose threshold for transient epilation is low (0.75-2 Gy) [30][31][32] and the singlefraction lethal dose for a hair follicle was historically considered to be 7 to 16 Gy, 7,33,34 the risk factors and dose thresholds for pRIA in patients with cancer receiving modern fractionated CRT are less clear.…”

Section: Discussion Pria Clinical Characteristicsmentioning

confidence: 99%

“…Newer treatment-planning modalities (eg, intensitymodulated radiotherapy, volumetric-modulated arc therapy) are preferable to traditional radiotherapy delivery modalities in terms of off-target dose delivery (eg, hair-sparing properties). 30,38,39 Other tactics with uncertain utility in decreasing skin dose include margin adjustment, blocking devices, limiting the use of fixation materials, scalp cooling, and topic al agents, including nitroxide compounds (eg, tempol). 21,35,[40][41][42][43] Patients should be counseled on discussing the risks of RIA and pRIA with their radiation oncologist, keeping their specific radiotherapy treatment planning dosing scheme in mind.…”

Section: Discussion Pria Clinical Characteristicsmentioning

confidence: 99%

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Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

et al. 2020

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IMPORTANCE Persistent radiation-induced alopecia (pRIA) and its management have not been systematically described.OBJECTIVE To characterize pRIA in patients with primary central nervous system (CNS) tumors or head and neck sarcoma. DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort study of patients from January 1, 2011, to January 30, 2019, was conducted at 2 large tertiary care hospitals and comprehensive cancer centers. Seventy-one children and adults diagnosed with primary CNS tumors or head and neck sarcomas were evaluated for pRIA. MAIN OUTCOMES AND MEASURESThe clinical and trichoscopic features, scalp radiation dose-response relationship, and response to topical minoxidil were assessed using standardized clinical photographs of the scalp, trichoscopic images, and radiotherapy treatment plans. RESULTSOf the 71 patients included (median [range] age, 27 [4-75] years; 51 female [72%]), 64 (90%) had a CNS tumor and 7 (10%) had head and neck sarcoma. Alopecia severity was grade 1 in 40 of 70 patients (56%), with localized (29 of 54 [54%]), diffuse (13 of 54 [24%]), or mixed (12 of 54 [22%]) patterns. The median (range) estimated scalp radiation dose was 39.6 (15.1-50.0) Gy; higher dose (odds ratio [OR], 1.15; 95% CI, 1.04-1.28) and proton irradiation (OR, 5.7; 95% CI, 1.05-30.8) were associated with greater alopecia severity (P < .001), and the dose at which 50% of patients were estimated to have severe (grade 2) alopecia was 36.1 Gy (95% CI, 33.7-39.6 Gy). Predominant trichoscopic features included white patches (16 of 28 [57%]); in 15 patients, hair-shaft caliber negatively correlated with scalp dose (correlation coefficient, −0.624; P = .01). The association between hair density and scalp radiation dose was not statistically significant (−0.381; P = .16). Twenty-eight of 34 patients (82%) responded to topical minoxidil, 5% (median follow-up, 61 [interquartile range, 21-105] weeks); 4 of 25 (16%) topical minoxidil recipients with clinical images improved in severity grade. Two patients responded to hair transplantation and 1 patient responded to plastic surgical reconstruction.CONCLUSIONS AND RELEVANCE Persistent radiation-induced alopecia among patients with primary CNS tumors or head and neck sarcomas represents a dose-dependent phenomenon that has distinctive clinical and trichoscopic features. The findings of this study suggest that topical minoxidil and procedural interventions may have benefit in the treatment of pRIA.

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Section: Discussion Pria Clinical Characteristicsmentioning

confidence: 99%

Section: Discussion Pria Clinical Characteristicsmentioning

confidence: 99%

Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

et al. 2020

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“…У онкологических больных алопеция является одним из наиболее частых осложнений лечения основного заболевания. У пациентов, получающих ЛТ на область головного мозга, костей черепа, может развиться временная алопеция (в течение нескольких месяцев) [74]. Клиническая картина в данном случае представляет собой участки выпадения волос, границы которых часто четко очерчены полями облучения [75].…”

Section: лучевая алопеция и радиодерматитunclassified

Radiation injuries of organs and tissues: mechanisms of occurrence, methods of prevention and treatment: A review

Balaeva,

Romanov,

Trofimova

et al. 2024

J. Mod. Onco.

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In modern medicine, radiation therapy (RT) is one of the main therapies for cancer. According to the World Health Organization, about 70% of patients diagnosed with cancer require RT at some stage of treatment. Development and improvement of methods for early diagnosis of cancers, multimodal therapy for cancer patients, including surgical intervention, new drug treatment regimens, modern methods of conformal 3D-RT and proton therapy significantly improved the treatment outcomes of patients and increased their life expectancy. Modern RT is a high-tech chain of sequential use of complex technical devices and mathematical calculations to destroy the tumor without adversely affecting the surrounding normal tissues. Some patients develop radiation injuries to normal organs and tissues that reduce their quality of life. Prevention and treatment of such injuries are urgent problems of modern oncology. The article addresses the pathogenesis and mechanism of the development of systemic and local radiation responses, as well as methods of treatment and prevention of some of them. Three electronic databases, including PubMed, Cochrane and EMBASE, and Russian radiotherapists' publications, were used for systematic review in the information retrieval process.

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“…In cancer patients, alopecia is one of the most common clinical presentations mainly due to cancer treatment. In patients receiving cranial radiation, acute and mostly temporary alopecia for several months is an example of a dose dependent side effect during radiotherapy [1] . The clinical presentation consists of non-scarring alopecia, which is often sharply demarcated in geometric shapes confined to the area of radiation [1] , [2] .…”

Section: Introductionmentioning

confidence: 99%

“…In patients receiving cranial radiation, acute and mostly temporary alopecia for several months is an example of a dose dependent side effect during radiotherapy [1] . The clinical presentation consists of non-scarring alopecia, which is often sharply demarcated in geometric shapes confined to the area of radiation [1] , [2] . The condition is mostly temporary, although permanent scalp alopecia is also reported [3] , [4] .…”

Section: Introductionmentioning

confidence: 99%

Pre-treatment visualization of predicted radiation-induced acute alopecia in brain tumour patients

Ven

Compter

Eijsden

et al. 2022

Clinical and Translational Radiation Oncology

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Radiation Induced Alopecia: An Under-Appreciated Side Effect of Whole Brain Radiotherapy and Strategies to Ameliorate it

Cited by 3 publications

References 0 publications

Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

Radiation injuries of organs and tissues: mechanisms of occurrence, methods of prevention and treatment: A review

Pre-treatment visualization of predicted radiation-induced acute alopecia in brain tumour patients

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