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

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.

Hair Loss Prevention by a Scalp Cooling Device in Early Breast Cancer Patients: The Poliambulanza Preliminary Experience

2019 ◽  
Vol 14 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Tiziana Prochilo ◽  
Alessandra Huscher ◽  
Federica Andreis ◽  
Mara Mirandola ◽  
Elisabetta Zaina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hair Loss ◽  
Depression Scale ◽  
Hair Follicles ◽  
Common Side Effect ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Cooling Device ◽  
End Of Treatment

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.

scholarly journals Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

2021 ◽  
Author(s):  
Shozo Ohsumi ◽  
Sachiko Kiyoto ◽  
Mina Takahashi ◽  
Seiki Takashima ◽  
Kenjiro Aogi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Prospective Study ◽  
Cancer Patients ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Chemotherapy Infusion ◽  
Group A ◽  
Neo Adjuvant Chemotherapy ◽  
Group B

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

Skin and mucosal alterations

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....

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

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e13539-e13539 ◽  
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.

scholarly journals Hubungan Lama Menjalani Kemoterapi Dengan Kualitas Hidup Penderita Kanker Payudara Di RSUD Ulin Banjarmasin

2020 ◽  
Vol 10 (1) ◽  
pp. 253-265
Author(s):  
Mahmuddin Mahmuddin ◽  
Dhian Ririn Lestari ◽  
Ichsan Rizani
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effect ◽  
Life Quality ◽  
P Value ◽  
Symptom Scale ◽  
Cross Sectional ◽  
European Organization ◽  
The Mean

 Latar Belakang: Kanker payudara adalah keganasan sel yang menyerang payudara dan merupakan penyebab kematian kedua pada wanita. Frekuensi kemoterapi menimbulkan gangguan pada fungsi dan gejala kanker payudara yang dapat mempengaruhi kualitas hidup. Kualitas hidup merupakan keadaan yang menyatakan kepuasan batin dan kenyamanan hidup seseorang. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan lama menjalani kemoterapi dengan kualitas hidup penderita kanker payudara di RSUD Ulin Banjarmasin Metode: Penelitian ini merupakan penelitian analitik dengan pendekatan cross sectional menggunakan accidental sampling didapatkan 47 responden, penilaian kualitas hidup menggunakan European Organization of Research and Treatment of Cancer (EORTC) BR23. Uji Analisa menggunakan korelasi spearman. Hasil: Hasil rata-rata lama penderita menjalani kemoterapi sebanyak 4,53 kali  dan rata-rata kualitas hidup penderita kanker payudara berada di 65, 5% . Kesimpulan: dari Hasil analisis didapatkan ada hubungan antara lama menjalani kemoterapi dengan kualitas hidup penderita kanker payudara di RSUD Ulin Banjarmasin (P Value=0,000,01) dengan arah hubungan positif yakni semakin lama menjalani kemoterapi semakin tinggi nilai kualitas hidup penderita kanker payudara. Kualitas hidup yang paling tinggi dilihat dari function scale adalah sexs enjoyment yakni 72,0  sedangkan dari symptom scale   adalah side effect dengan skor 582,6 Kata kunci : kanker payudara, kemoterapi, kualitas hidup.Long Relationship Undergo Chemotherapy with Quality of Life of Breast Cancer Patients in Ulin Hospital BanjarmasinAbstractBackground: Breast cancer is a malignancy cells that attack breast and it is also the second leading cause of death among women. Frequency of chemotherapy may have detrimental function and symptom can make affect for patient’s quality of life. Quality of life is defined as condition to which individual reports inner satisfaction and comfort in life. Aim:The study to identify correlation between duration of chemotherapy and quality of life in patients with breast cancer RSUD Ulin Banjarmasin Method: This Research use Analitic Method with  design was cross sectional and involved 47 patients, all of whom were selected through accidental sampling. European Organization of Research and Treatment of Cancer (EORTC) BR23 was applied to measure patient’s quality of life. Anlyssis test using spearman correlation. Result: The mean of chemotherapy duration among participants was 4.53 times and the mean of QoL of patients with breast cancer was 73.31%. Conclusion: The analysis revealed a significant correlation between duration of chemotherapy and quality of life in patients with breast cancer in Ulin public hospital of Banjarmasin (p value = 0.000.01) with positive direction of association indicating that the longer the duration of make increase the score life quality of patients with breast cancer. The highest quality of life seen from the function scale is sex enjoyment, namely 72.0 while the symptom scale   is a side effect with a score of 582.6. Key words: breast cancer, chemotherapy, quality of life 

Efficacy of scalp cryotherapy in preventing alopecia among patients with breast cancer patients receiving adjuvant docetaxel and cyclophosphamide.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20641-e20641
Author(s):  
Tessa Cigler ◽  
Barbara Fiederlein ◽  
Sarah E. Schneider ◽  
Ellen Chuang ◽  
Linda T. Vahdat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hair Loss ◽  
Chemotherapy Regimen ◽  
Early Stage ◽  
Breast Cancer Patients ◽  
Chemotherapy Treatment ◽  
A Prospective Study ◽  
Chemotherapy Agents ◽  
Head Covering

e20641 Background: Chemotherapy induced alopecia (CIA) is a distressing adverse effect of many chemotherapy agents. The TC chemotherapy regimen (four cycles of docetaxel 75mg/m2 and cyclophosphamide 600mg/m2 given every 3 weeks apart) commonly used for aduvant therapy of breast cancer is associated with complete alopecia, with rare reports of permanent alopecia. Scalp cryotherapy has been reported to minimize or prevent CIA. Penguin cold caps are a commercially available scalp cooling product gaining increasing media attention. We conducted a prospective study aimed to assess efficacy of scalp cryotherpy in preventing CIA among women receiving adjuvant TC chemotherapy for early stage breast cancer who independently elected to use Penguin cold caps. Methods: Women at the Weill Cornell Breast Center who elected to use scalp cryotherapy with Penguin cold caps during adjuvant TC chemotherapy were asked to participate in the study. Degree of hair loss was rated by practitioner assessment using Dean’s alopecia scale (poor (>75% hair loss), moderate (50-75%), good (25-50%) or excellent (<25%)), by digital photographs, and by asking patients whether they felt a need to wear a wig or head covering due to hair loss. Assessments were made before each chemotherapy treatment and at a follow up visit between 3 weeks and 3 months after the completion of chemotherapy. Results: 17 patients have enrolled. 13 patients have completed chemotherapy. 2 patients currently undergoing chemotherapy and 2 patients who discontinued chemotherapy due to toxicity not related to alopecia are excluded from analysis. Dean’s alopecia scale score was excellent for 10 patients (77%) at every assessment. Dean’s score was good for 2 participants (15%) and moderate for 1 participant (8%) starting prior to fourth cycle of chemotherapy. Only 1 patient (8%) reported needing to wear a wig or head covering as a result of alopecia. Conclusions: Scalp cryotherapy using Penguin cold caps appears to be effective in preventing CIA among women undergoing chemotherapy with the TC regimen.

Obesity and guideline-concordant systemic therapy for locoregional breast cancer.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 145-145
Author(s):  
Hollis Moore ◽  
Amy Trentham-Dietz ◽  
Caprice Christian Greenberg ◽  
David J. Vanness ◽  
John M Hampton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Systemic Therapy ◽  
Chemotherapy Regimen ◽  
Specific Treatment ◽  
Individual Therapy ◽  
P Value ◽  
Breast Cancer Patients ◽  
Adequate Treatment

145 Background: Obese breast cancer patients tend to have higher mortality than non-obese patients. Hypothesizing that differences in receipt of adequate treatment may contribute to this mortality differential, we examined whether breast cancer patients with higher body mass index (BMI) received systemic adjuvant treatment consistent with National Comprehensive Cancer Network guidelines. Methods: Female adult stage I-III breast cancer cases diagnosed in 2004 were identified from population-based cancer registries in 7 states and supplemented with abstracted medical records. Differences in receipt of concordant treatment according to BMI were investigated using logistic regression models adjusted for age and other covariates. Results: Among all women, 57% (2,174 of 3,828) received overall guideline-concordant (GC) adjuvant systemic treatment, meaning treatment adherent in each of 3 defined domains: chemotherapy, chemotherapy regimen, and hormonal therapy. Within the domains, 82% of women received GC chemotherapy, and 93% of those received a GC regimen, and 80% received GC hormonal therapy. Women with higher BMI had greater odds of receiving GC systemic therapy (odds ratio for each 5 kg/m2 increase in BMI 1.07, 95% CI 1.01 to 1.14; p value for trend = 0.04). No significant differences in guideline treatment according to BMI were found in the individual therapy domains (adjuvant chemotherapy, p = 0.18; chemotherapy regimen, p = 0.26), although a borderline significant, nonlinear pattern was seen for hormonal therapy, in which the highest odds of GC treatment were found in the lowest and highest BMI ranges (p = 0.07 from χ2 test). Conclusions: Contrary to our hypothesis, odds of guideline concordant systemic therapy increased with higher BMI, and no significant differences were found within any specific treatment domain. Further research describing how multiple factors including treatment patterns influence outcomes for obese breast cancer patients may identify areas where changes in practice can reduce disease burden and mortality. Our research also suggests further investigation into patterns of care for underweight patients.

Scalp Cooling Alopecia Prevention trial (SCALP) for patients with early stage breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10088-10088 ◽  
Author(s):  
Julie R. Nangia ◽  
Tao Wang ◽  
Cynthia R. C. Osborne ◽  
Polly Ann Niravath ◽  
Kristen Otte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Randomized Trial ◽  
Interim Analysis ◽  
Randomized Trials ◽  
Early Stage ◽  
Control Group ◽  
P Value ◽  
Scalp Cooling ◽  
Success Rates

10088 Background: Adjuvant chemotherapy decreases the risk of recurrence. However, it has distressing side effects, including alopecia. There are no randomized trials assessing modern scalp cooling to prevent alopecia, and success rates in non-randomized trials have varied. Methods: We conducted a multi-center randomized trial to evaluate the safety and efficacy of the Orbis Paxman Hair Loss Prevention System (OPHLPS) in reducing chemotherapy-induced alopecia. Women with stage I-II breast cancer planned to receive anthracycline- or taxane- based chemotherapy for at least four cycles were eligible and randomized in a 2:1 ratio to scalp-cooling or control. Scalp-cooling was done with the OPHLPS 30 minutes prior to, during and 90 minutes after each chemotherapy. The primary efficacy endpoints were hair preservation and device safety. We planned to enroll 235 subjects to provide 85% power to detect a 20% difference in hair preservation. Secondary endpoints included wig/scarf use and quality of life assessed by the EORTC QLQ-30, HADS and BIS. Subjects will be followed for 5 years for recurrence, overall survival, and site of recurrence. One interim analysis was planned to allow the study to stop early for efficacy after 142 subjects were enrolled and evaluable for the primary endpoint. To maintain the overall type 1 error rate, an O’Brien-Fleming spending function was used (interim boundary p = 0.0061). Results: This is the first randomized trial with modern scalp cooling in the world. For the interim analysis, 142 subjects were evaluable. Among them, 48 (50.5%) out of 95 in the cooling group and 0 (0%) out of 47 in the control group had hair preservation. The one-tailed p-value from the Fisher’s exact test is < 0.0001, which crosses the superiority boundary (p = 0.0061). Thus on 9/26/2016 the DSMB stopped the study early. The interim analysis was presented at SABCS 2016. There are 195 subjects enrolled on this clinical trial, and the final subject will be evaluable for the primary outcome February 2017. The final analysis will be presented. Conclusions: Our trial showed that scalp cooling using OPHLPS is highly effective in hair retention. Paxman Coolers has applied for FDA clearance for the OPHLPS based on the results of the interim analysis. Clinical trial information: NCT01986140.

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