Scalp cooling successfully prevents alopecia in breast cancer patients undergoing anthracycline/taxane-based chemotherapy

Vasconcelos, Inês; Wiesske, Alexandra; Schoenegg, Winfried

doi:10.1016/j.breast.2018.04.012

Cited by 42 publications

(31 citation statements)

References 10 publications

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“…Our study suggests that women with breast cancer who received SC with both A and T chemotherapy were significantly more likely (57% versus 0%) to have successful HP than those who did not receive SC. This is consistent with results from recent studies which show success of scalp cooling in ∼30–80% patients [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ]. Also, though SC has mostly been studied in females undergoing treatment for breast cancer, many of the studies are in patients with early breast cancer [ 13 , 14 , 16 , [26] , [27] , [28] , [29] ].…”

Section: Discussionsupporting

confidence: 93%

“…A meta-analysis as well as other randomized control trials (RCTs) showed positive results with SC with acceptable tolerance [ 9 , [12] , [13] , [14] ]. Various other non-randomized studies have also reported beneficial outcomes with SC [ [15] , [16] , [17] , [18] , [19] ]. However, in most studies, taxanes (T) were preferentially used, and only CIA was measured, not hair regrowth (HR), which is also an important landmark towards attaining normalcy [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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“Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia”

et al. 2020

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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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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

“Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia”

et al. 2020

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“…This could partially explain the high overall success rate of 68%, which is comparable to those in similar recent studies. [2938]…”

Section: Discussionmentioning

confidence: 99%

Scalp Cooling in Daily Clinical Practice for Breast Cancer Patients Undergoing Curative Chemotherapy: A Multicenter Interventional Study

Gianotti

Razzini

Bini

et al. 2019

Asia-Pacific Journal of Oncology Nursing

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Objective: Chemotherapy-induced alopecia is a common and distressful side effect, especially among breast cancer patients. Scalp cooling (SC) can reduce hair loss during anthracycline- and taxane-based chemotherapy. This study assessed the effectiveness of SC in daily clinical practice in three Italian oncology units. Methods: From 2014 to 2016, we prospectively included 220 female early-stage breast cancer patients undergoing curative chemotherapy in combination with SC using the Paxman device. Effectiveness was defined as the severity of hair loss according to the Common Terminology Criteria for Adverse Events Version 4.0 as follows: Grade 0, no hair loss; Grade 1, <50% hair loss not requiring a wig; and Grade 2, ≥50% hair loss at each cycle and at completion of chemotherapy. The tolerability and safety were also evaluated. Results: The overall success rate of SC (hair loss Grade 0–1) was 68%. Severe hair loss was avoided in 89% of women receiving taxane-based chemotherapy and in 78% of women receiving both anthracyclines and taxanes. Among women undergoing anthracycline-based chemotherapy, 47% experienced hair preservation. SC was well tolerated, as only 20 patients discontinued SC for reasons other than hair loss. Conclusions: Our study confirmed that SC provides a reliable chance for breast cancer patients to keep their hair during taxane- and/or anthracycline-based chemotherapy.

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“…Ve studii SCALP u žen s karcinomem prsu stadia I-II léčených chemoterapií s ta xany, antracykliny nebo oběma byla úspěšná ochrana před alopecií (ztráta vlasů do 50 %) pozorována v případě chlazení u 50,5 % žen, s obecně hor šími výsledky (16 %) při léčbě zahrnující antracykliny [20]. V jiné recentní studii u 131 pacientek byla ztráta vlasů do in tenzity méně než 50 % pozorována v pří padě zajištění chlazení u 71 % pacientek léčených taxany nebo taxany s antra cykliny [21]. Obecně metoda chlazení kštice zabrání totální alopecii přibližně u 50-80 % pacientek, u většiny dosáhne stupeň poškození hodnoty 0-2 na škále dle Deanové [1,22,23].…”

Section: Závěrunclassified

Alopecia and Hair Damage Induced by Oncological Therapy

Jedličková¹,

Vokurka²,

Vojtíšek³

et al. 2019

Klin Onkol

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Poškození a ztráta vlasů (alopecie) jsou předvídatelným nežádoucím účinkem onkologické léčby. Mohou být způsobeny chemoterapií či radioterapií v oblasti hlavy a krku, příp. i cílenou a hormonální léčbou. Ztráta vlasů patří k nejobávanějším nežádoucím účinkům léčby z pohledu pacientů, kteří se současně vyrovnávají s realitou onkologického onemocnění. Ztráta vlasů může být difuzní, kompletní, částečná nebo ložisková, dochází též ke zhoršení kvality vlasů, příp. zá nětu a jizvení pokožky. Výpadek postihuje i řasy, obočí i ochlupení těla. Alopecie je většinou reverzibilní, může ale dojít i k trvalému poškození v závislosti na typu, celkové délce, dávce on kologické léčby a řadě dalších individuálních faktorů. Zvýšené riziko alopecie mají vysoké dávky docetaxelu, doxorubicinu, cyklofosfamidu, nízké riziko je spojeno s preparáty platiny, melfala nem, kapecitabinem. U cílené terapie a imunoterapie pozorujeme imunitně podmíněné alope cie, jako je alopecie areátní a jizvící, ale paradoxně i hypertrichózu a trichomegalii. Existují mož nosti fyzikální i farmakologické prevence a léčby alopecie, jejich účinnost a dostupnost je však limitována. Výpadek vlasů se daří redukovat u moderních metod radioterapie, které šetří oblast kštice. Dobré výsledky má chlazení kštice během krátkých infuzních režimů, které omezuje to xický účinek cytostatika na vlasový folikul. K dispozici je několik chladicích systémů s ochlazením pokožky pod 22 °C. V lokální terapii se používá minoxidil, který urychluje zarůstání kštice. Velmi důležitá je psychologická podpora a dostupnost kosmeticky přijatelných náhrad. Klíčová slova alopecie-chemoterapie-radioterapie-hormonální léčba-cílená léčba-nežádoucí účinky-kvalita života-hirsutizmus

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Scalp cooling successfully prevents alopecia in breast cancer patients undergoing anthracycline/taxane-based chemotherapy

Cited by 42 publications

References 10 publications

“Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia”

“Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia”

Scalp Cooling in Daily Clinical Practice for Breast Cancer Patients Undergoing Curative Chemotherapy: A Multicenter Interventional Study

Alopecia and Hair Damage Induced by Oncological Therapy

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