MO11-6 Scalp cooling on chemotherapy can escape from hair loss

Background: The most effective agents in the treatment of breast cancer have a common side effect, the hair loss. Some studies reported a reduction of hair loss with the use of the scalp cooling device. Indeed, it decreases the drug accumulation in the hair follicles. We report our preliminary experience with a scalp cooling device in reducing chemotherapy-induced alopecia and related distress in breast cancer patients undergoing adjuvant chemotherapy. </P><P> Methods: Hair loss grading and treatment tolerability were evaluated during chemotherapy every 21 days and 3 weeks after the last cycle of chemotherapy via Dean’s scale by patients and operators and a comfort analogic scale by patients. We administered the Hospital Anxiety and Depression Scale questionnaire at the baseline and at the end of treatment to assess the distress related to chemotherapy- induced alopecia. Results: Among the 46 patients identified, 27 accepted the device. The eligible chemotherapy regimens included docetaxel+cyclophosphamide (TC), doxorubicin+cyclophosphamide (AC) and paclitaxel (P) weekly+trastuzumab (T). 24 pts (89%) completed the treatment; 3 pts (11%) treated with AC prematurely interrupted use of the scalp-cooling device due to inefficacy. After the last cycle of chemotherapy, the number of patient who perceived a HL < grade 2 was 16 (59%). The hair retention reported by operators has been higher (78%). 81.5% of patients well tolerated the treatment. Conclusion: In our study, the scalp-cooling device reduced chemotherapy-induced alopecia in taxane- based chemotherapy. Furthermore, it suggests a discordance in hair loss perception between patients and operators.

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The use of scalp cooling for chemotherapy-induced hair loss

British Journal of Nursing ◽

10.12968/bjon.2016.25.10.s22 ◽

2016 ◽

Vol 25 (10) ◽

pp. S22-S27 ◽

Cited By ~ 3

Author(s):

Annie Young ◽

Azra Arif

Keyword(s):

Hair Loss ◽

Scalp Cooling

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Skin and mucosal alterations

Oxford Handbook of Cancer Nursing ◽

10.1093/med/9780198569244.003.0053 ◽

2007 ◽

pp. 635-652

Keyword(s):

Body Image ◽

Cancer Treatment ◽

Advanced Cancer ◽

Oral Mucositis ◽

Hair Loss ◽

Side Effect ◽

Oral Care ◽

Scalp Cooling ◽

It Impacts ◽

Scalp Hypothermia

Hair loss (alopecia) 636 Scalp cooling (scalp hypothermia) 638 Oral mucositis and related problems 640 Oral mucositis: managing the process and symptoms 644 Oesophagitis 646 Oral care in advanced cancer 647 Malignant wounds 648 Lymphoedema 650 Hair loss can be a distressing side effect of cancer treatment; it impacts on body image and feelings of attractiveness, creates anxiety and causes a visual reminder of the disease and treatment. Alopecia is not a major side effect for most people, but a small group of patients will become extremely distressed by it....

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Scalp cooler efficacy to reduce anthracycline-induced alopecia and its QOL impact in breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e13539 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e13539-e13539 ◽

Cited By ~ 2

Author(s):

R. O. El-saka ◽

G. El-Husseiny ◽

Y. Rostom ◽

A. Salama

Keyword(s):

Breast Cancer ◽

Body Image ◽

Hair Loss ◽

Emotional Functioning ◽

Performance Status ◽

The Body ◽

Control Group ◽

Scalp Cooling ◽

Moderate Disturbance

e13539 Background: Hair loss is a common, unavoidable, and stressful side effect of chemotherapy. This work was performed to evaluate the role of scalp cooling in reducing anthracycline-induced hair loss and its impact on Quality of life (QOL). Methods: The study was conducted from July 2007 to August 2008. It included 120 females with breast cancer, treated in adjuvant setting. Patients were chosen according to certain criteria (age ≤ 70 years, WHO performance status 0–1, no cardiac disease, no serious psychiatric conditions, no previous chemotherapy). Patients were divided randomly into 2 groups according to whether scalp cooler was used or not during chemotherapy. Chemotherapy consisted of doxorubicin (50 mg/m2), 5-FU (500 mg/m2) and cyclophosphamide (500 mg/m2) for 6 cycles. Paxman Scalp Cooler was used. The cap was applied 20 minutes before, during and 2 hours after infusion. Hair loss was assessed using WHO criteria at each cycle and after 6 cycles of chemotherapy. QOL was assessed using EORTC QLQ-C30 and BR23. Results: After 4 cycle, 61.7 % of patients in scalp cooling group had grade 4 hair loss compared to 81.7 % of patients in control group. After 6 cycles, 85% of patients in scalp cooling group experienced grade 4 hair loss compared to 100% of patients in the control group. Only 9 patients (15%) in the scalp cooling group developed grade 1–2 hair loss. No significant relation was found between the degree of hair loss and the liver function tests. Most patients (73.3%) were comfortable during cooling. QOL scores were comparable between the two groups except for emotional functioning and body image. In the hair loss group, 71.2% of patients showed severe disturbance of emotional functioning and 54.1% of patients had moderate disturbance in body image. In hair preservation group (9 patients), 77.8% developed moderate disturbance of emotional functioning and all patients had mild disturbance in the body image. Conclusions: The role of scalp cooling is limited at the total dose of 300 mg/m2 doxorubicin. It may be more effective with fewer cycles or less aggressive drug combination. Hair loss affects various aspects of QOL, especially emotional functioning and body image. More time is needed to assess the long term effect of hair loss on QOL and the incidence of scalp metastasis in the two study groups. No significant financial relationships to disclose.

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Effectiveness of scalp cooling in reducing chemotherapy-induced alopecia: A single center prospective study in Lebanon.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e12075 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e12075-e12075

Author(s):

Nour Haidar ◽

Lewis Nasr ◽

Fadi Nasr

Keyword(s):

Breast Cancer ◽

Prospective Study ◽

Hair Loss ◽

Side Effect ◽

Chemotherapy Regimen ◽

Stage I ◽

P Value ◽

Scalp Cooling ◽

Multiple Cycles ◽

The One

e12075 Background: Hair loss (alopecia) is recognized as one of the most common and distressing side effects of chemotherapy. The scalp cooler first used in 1970s against the Chemotherapy CIA (chemotherapy induced alopecia). This study aimed at assessing the effectiveness of scalp cooling (PAXMAN Cooler ORBIS II SCALP COOLER) in reducing chemotherapy-induced alopecia. Methods: This prospective study was conducted at the Mount-Lebanon Hospital in the one day chemotherapy between 01 January 2017 and 31 December 2018. 109 women diagnosed with breast cancer with stage I or II undergoing neoadjuvant, and adjuvant chemotherapy were enrolled. Patients with scalp cooling 54.1% (n=59), control 45.9 % (n=50). Scalp cooling done by using the scalp cooling device. The primary end point was to assess the hair loss using the dean’s scale after multiple cycles of chemotherapy. The clinical assessment and alopecia evaluation were done after each chemotherapy cycle. The secondary endpoint was the side effect of the scalp cooler such as headache. Results: The Mean age was 55.73 ± 11.9 years. 82.56 %received Anthracycline-based chemotherapy regimen with Docetaxel, and 14.69 % Anthracycline-based chemotherapy regimen with Paclitaxel and 2.75 % took only anthracycline with cyclophosphamide. The effectiveness of hair preservation was successfully reported as 62.7% grade 0, 22.01 % grade 1 and 15.29% grade 2. There were highly significant differences between patients underwent scalp cooling and patients without scalp cooling with different regimens of chemotherapy (P value <0.0001). The major side effect, the headache where was reported in 25.7% from the total (P value <0.0001). Conclusions: Hair preservation in stage I , II breast cancer undergoing multiple regimens of chemotherapy was significantly more effective in the scalp cooling group.

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What is wrong with the 30-year-old practice of scalp cooling for the prevention of chemotherapy-induced hair loss?

Supportive Care in Cancer ◽

10.1007/s00520-003-0551-8 ◽

2004 ◽

Vol 12 (1) ◽

pp. 3-5 ◽

Cited By ~ 8

Author(s):

Wim P. M. Breed

Keyword(s):

Hair Loss ◽

Scalp Cooling

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Effectiveness and Reliability of Scalp Cooling in Preventing Hair Loss Caused by Chemotherapy

Kocaeli Medical Journal ◽

10.5505/ktd.2021.53325 ◽

2021 ◽

Vol 10 (60) ◽

pp. 133-140

Author(s):

Veysel Haksöyler ◽

Tolga Koseci ◽

Polat Olgun ◽

Ertuğrul Bayram ◽

Mehmet Ali Çaparlar

Keyword(s):

Hair Loss ◽

Scalp Cooling

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Scalp cooling to reduce alopecia as a barrier to chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12537 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12537-e12537

Author(s):

Isabel M. Pupo Wiss ◽

Dina Hagigeorges ◽

Chloe J. Walker ◽

Kelly E. Flanagan ◽

James T. James ◽

...

Keyword(s):

Hair Loss ◽

Post Treatment ◽

Common Disease ◽

Scalp Cooling ◽

Treatment Regimens ◽

Asian Patients ◽

Patient Reported ◽

Distress Scale ◽

The Impact ◽

To Receive

e12537 Background: Chemotherapy induced alopecia (CIA) is one of the most distressing adverse events reported by patients undergoing chemotherapy, yet there is limited data addressing the impact of CIA on treatment acceptance. Scalp cooling (SC) has been shown to decrease CIA. Here we report our assessment of CIA as a barrier to chemotherapy and the efficacy of SC using pre- and post-treatment surveys of patient reported outcomes. Methods: Patients who received alopecia-inducing chemotherapy and utilized SC between November 2018 and September 2020 at our institution were enrolled in a prospective IRB approved registry. Surveys including the Chemotherapy Induced Alopecia Distress Scale (CADS) were administered before and within two weeks after treatment. Using the CADS survey, patients were asked about their hesitation to receive chemotherapy and the burden they feel about alopecia as a side effect of chemotherapy. Results: Of 90 patients who completed the first or last treatment survey, the most common treatment regimens were docetaxel/cyclophosphamide (TC), docetaxel/carboplatin/trastuzumab/ pertuzumab (TCHP), and paclitaxel/trastuzumab (TH). The most common disease type was breast cancer (92.2%) and all participants were females. Of 74 SC patients who completed the pre-treatment survey, the median age was 50.5 (range 26-75) and included 65 (87.8%) Caucasian, 4 (5.4%) Black, and 3 (4.0%) Asian patients. 89.2% used Paxman SC and 10.8% used Penguin SC. Of those who completed the CADS survey prior to treatment, 8 (10.8%) reported ‘quite a bit’ to ‘very high’ hesitation, and 34 (46.0%) reported feeling that alopecia was either ‘quite’ or ‘very much’ a burden of chemotherapy. All 40 SC patients (median age 53.5, range 31-76) who completed the post-treatment survey were Caucasian and used Paxman SC. Self-reported efficacy of SC in these 40 patients was less than 10% hair loss in 10 (25.0%), 11-25% hair loss in 7 (17.5%), 26-50% hair loss in10 (25.0%), 51-75% hair loss in 9 (22.5%), and 76-100% hair loss in 4 (10%). Overall, 27 (67.5%) patients reported SC limited alopecia ‘a lot’ to ‘perfectly’. Conclusions: In our study, alopecia was identified as a notable burden to nearly half our SC patients and 10.8% hesitated when making their decision to receive chemotherapy. After using SC during treatment, 67.5% of patients reported less than 50% hair loss, and 67.5% reported that SC reduced alopecia ‘a lot’ or ‘perfectly’. Our study highlights the significance of alopecia as a chemotherapy burden and potential barrier to accepting treatment, and suggests SC may be efficacious in decreasing CIA, which may allow patients to feel less hesitation towards chemotherapy.

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Real-world data on usage of scalp cooling for chemotherapy associated alopecia in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18739 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18739-e18739

Author(s):

Nicole Olivia Williams ◽

Richard Paxman ◽

Emma Thornhill ◽

Mahmoud Kassem ◽

Michael Grimm ◽

...

Keyword(s):

Hair Loss ◽

Real World ◽

The United States ◽

Scalp Cooling ◽

Real World Data ◽

The Real ◽

System A ◽

The Usa ◽

Number Of Cycles ◽

Cancer Network

e18739 Background: Hair loss is a well-known side effect of chemotherapy. The Paxman Hair Loss Prevention System, a scalp cooling device, has been shown to be effective in reducing chemotherapy induced alopecia in patients receiving chemotherapy (Nangia, JAMA, 2017). The National Comprehensive Cancer Network and the European Society for Medical Oncology guidelines have recommended scalp cooling as category 2A and 2B options, respectively. Methods: The real world use of scalp cooling using the Paxman device, as documented by orders through the Paxman Hub during the years of 2017-2020 was summarized. Descriptive statistics were used to summarize demographics and utilization. Results: Data from 6649 patients who used scalp cooling were reviewed. Patients with breast cancer were the most common users of scalp cooling (78%, n=5197) followed by gynecology (12%, n=775), gastrointestinal (3%, n=201), lung (1%, n=81) and genitourinary (1%, n=52). The majority of patients were between the ages of 45-65 (55%), followed by 65-74 (18%), older than 75 (5%), and 25-44 (2%). Average number (#) of cycles of cooling completed was 6.53 (range of average # of cycles 4.50-12). Scalp cooling with this device was commonly used in 39 out of 50 states. Conclusions: This is the largest report of scalp cooling usage in the real world setting in the USA, including scalp cooling usage in older adults. Uptake of scalp cooling across various cancers has not been uniform and this deserves further study.

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