scalp cooling
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2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Yang J ◽  
◽  
Li N ◽  

CIA (Chemotherapy Induced Alopecia) is a common side effect seen during cancer treatment and a distressing symptom in many types of cancer patients. Patients exposed with alopecia during cancer treatment were accompanied by social influences and further quality of life. Although hair regrows in 3-6 months after chemotherapy, the regrown hair has changes in color, structure, texture etc. In the United States, chemotherapeutic patients had alopecia in varying degrees, where woman patients considered CIA as the most severe trauma, and even refused proper chemotherapy or have chosen an alternative therapy. Furthermore, the reported conditions of permanent CIA have been increasing. The CIA measures are mainly assessed using NCI-CTCAE, CTC, WHO, and GPA. Etiologically, CIA might be caused by therapeutic agents, genes and hormones. Diagnosis includes CST (Cross-Section Trichometry), Trichoscopy and OCT (Optical Coherence Tomography). Currently, the mainly reported used prevention of CIA is scalp cooling, and FDA has classified the scalp cooling system into class II (special controls) to provide a reasonable assurance of safety and effectiveness of the device. Scalp cooling is influenced by temperature, therapeutic agents, time and physiological factors. Besides physical interventions, several novel methods have been reported in animal models recently including drug-specific antibodies, hair growth cycle modifiers, cytokines, growth factors, antioxidants, cell cycle/proliferation modifiers or inhibitors of apoptosis, LLLT (Low-Level Laser Therapy), many drug preventions being under preclinical research. Thus, this review explores the current clinical treatment and future researches.


Background: Hair is a human characteristic, which has an important role in presenting the individual gender, race, nation, social interaction as well as mental and physical health status. Chemotherapy-induced alopecia (CIA), which has an incidence of 65%, is known to be one of the most psychological shocks among cancer patients. Chemotherapy-induced Alopecia Distress Scale (CADS) created by a group of Korean scientists is a new tool developed to evaluate alopecia’s effects on patients’ mentality. It is necessary to investigate the effects of alopecia on cancer patients and to understand the demands of patients in coping with CIA. However, to our knowledge, this is a topic that is still lacking objective and scientific evidence in Hue, Vietnam. Therefore, we conducted the study to describe the alopecia characteristics of patients treated with chemotherapy, and to identify the distress level of cancer patients using CADS and the preference of patients to deal with the alopecia. Methods: A cross-sectional study was conducted on 56 cancer patients undergoing chemotherapy at the Oncology department of Hue University of Medicine and Pharmacy Hospital from 01/12/2020 to 25/03/2021. The hair loss grade was assessed by CTCAE and the level of distress was evaluated by CADS. Statistical analysis was performed in Microsoft Excel 2016 and the R 3.6.0 program. Results: The mean age of patients in our study was 56.48 ± 10.244. Of all 56 patients, the majority of participants were female (69.6%), married (82.1%), and had above-average economic status (67.9%). Breast cancer patients accounted for the highest percentage with 39.3%. Most of the patients were in grade III (32.1%) and grade IV (39.3%). Our study revealed that 82.1% of patients having hair loss at grade 2 according to CTCAE 5.0. Evaluating by CADS showed that 87.5% of participants experienced low distress. Hat/ headscarf and wig were the most popular coping strategy against the CIA (66.1% and 35.7%, respectively). Scalp cooling is a new method that can prevent the CIA effectively. A proportion of 41.1% was willing to try the scalp cooling systems. Conclusions: Alopecia grade 2 accounted for the majority of patients in our study (82.1%). This was a symptom that should be concerned, however, our study revealed that the alopecia’s effects were not so serious among patients in the study. Most of the patients did not worry about chemotherapy - induced alopecia (89.3%), and 87.5% of participants experienced low distress, while there was still a proportion of 12.5% with higher distress. To cope against alopecia, many feasible coping strategies have been used by patients, including hat/ headscarf or wig.


2021 ◽  
pp. OP.21.00273
Author(s):  
Madison Novice ◽  
Taylor Novice ◽  
N. Lynn Henry ◽  
Kyle Johnson ◽  
Jacqueline S. Jeruss ◽  
...  

PURPOSE: Scalp cooling therapy (SCT) is the most effective method to reduce chemotherapy-induced alopecia (CIA), a highly distressing side effect of cancer treatment. Despite data supporting SCT efficacy and safety, SCT use in the United States is not widespread. Oncologists' interactions with scalp cooling were examined to identify facilitators and barriers to SCT implementation. METHODS: A 33-question survey was distributed through the ASCO Research Survey Pool to a nationally representative, random sample of 600 oncology providers. Outcome measures included knowledge of SCT, frequency of initiating conversations about SCT with patients, degree of support, and barriers for SCT. Significance was defined as P < .001. RESULTS: Of 155 (25.8%) responding providers, 62% of providers were in favor of SCT always or most of the time, but only 26% reported initiating discussions about SCT always or most of the time. Providers who treat breast cancer ( P ≤ .0001), those who report being very familiar with SCT ( P ≤ .0001), those who report having read SCT literature in the past 2 years ( P ≤ .0001), and those who work at a facility with machine SCT ( P ≤ .0001) were significantly more likely to initiate conversations with patients about SCT. Financial concerns (58%) were the primary reason for not recommending SCT use; efficacy (31%), staff or facility (24%), and safety (15%) concerns were also noted. Although safety concerns have decreased markedly over time, 14% of providers report patients who continue to express these concerns and 17% of providers see safety issues as barriers to supporting SCT. CONCLUSION: Our findings suggest that oncology provider familiarity and experience with SCT lead to increased support for scalp cooling, which may ultimately result in greater availability and utilization of SCT when indicated.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3915
Author(s):  
Leni van Doorn ◽  
Mandy M. van Rosmalen ◽  
Wendy M. van der Deure ◽  
Esther Oomen-de Hoop ◽  
Robert Porrazzo ◽  
...  

Chemotherapy-induced alopecia (CIA), a side effect with high impact, can be prevented by cooling the scalp during the administration of some cytotoxic drugs. However, the effects of this prolonged scalp cooling on the pharmacokinetics of chemotherapy have never been investigated. In this study, we compared the pharmacokinetics of the widely used chemotherapeutic agent paclitaxel (weekly dose of 80–100 mg/m2) in female patients with solid tumors using concomitant scalp cooling (n = 14) or not (n = 24). Blood samples were collected in all patients for pharmacokinetic analyses up to 6 h after one course of paclitaxel administration. The primary endpoint was the clearance (L/h) of paclitaxel. Paclitaxel clearance—expressed as relative difference in geometric means—was 6.8% (90% CI: −16.7% to 4.4%) lower when paclitaxel was administered with concomitant scalp cooling versus paclitaxel infusions without scalp cooling. Within the subgroup of patients using scalp cooling, paclitaxel clearance was not statistically significantly different between patients with CIA (alopecia grade 1 or 2) and those without CIA. Hence, scalp cooling did not negatively influence the clearance of paclitaxel treatment.


2021 ◽  
pp. 100842
Author(s):  
Cristina Mitric ◽  
Brian How ◽  
Emad Matanes ◽  
Zainab Amajoud ◽  
Hiba Zaaroura ◽  
...  

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