Efficacy of Scalp Cooling in Preventing Chemotherapy-Induced Alopecia in Breast Cancer Patients Receiving Adjuvant Docetaxel and Cyclophosphamide Chemotherapy
- Study type
- Observational study
- Design
- Prospective single-centre study (no control group)
- Sample size
- 20 evaluable patients
- Source
- Clinical Breast Cancer · 2015
In plain words
Hair loss is one of the most upsetting side effects of chemotherapy, and the docetaxel and cyclophosphamide regimen usually causes complete hair loss. In this small study, women with breast cancer used a cold cap to cool the scalp during chemotherapy. Most of them lost little hair, and only 10% later needed a wig or head covering. No one stopped treatment because the cold cap was uncomfortable, but most patients noticed some hair thinning.
Key results
Treatment arms and regimens
Adjuvant TC chemotherapy (docetaxel [Taxotere] and cyclophosphamide) with scalp cooling using a cold cap.
The dose of the TC regimen is not given in the abstract of this study.
Source of the regimen details: Abstract of the paper (the doses of the TC regimen are not given in the abstract)
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Women attending the Weill Cornell breast centre who, while receiving adjuvant TC chemotherapy (docetaxel and cyclophosphamide) for breast cancer, had independently decided to use scalp cooling with a cold cap and were invited to take part in the study.
Endpoints
Hair loss was assessed by a single physician using the Dean hair-loss scale: grade 1/excellent (hair loss less than 25%), grade 2/good (25 to 50% loss), grade 3/moderate (50 to 75% loss) and grade 4/poor (more than 75% loss). Digital photographs and patient reports of hair thinning or need for a wig/head covering (or both) were also used. Assessments were made before each chemotherapy cycle and at follow-up visits between 3 weeks and 3 months after the end of chemotherapy. The abstract does not specify a separate primary endpoint.
Safety and side effects
No patient stopped treatment because of intolerance of the cold cap. Other adverse event data are not reported in the abstract.
Clinical significance and place in guidelines
This small prospective study suggests that scalp cooling with a cold cap may prevent hair loss in most women receiving adjuvant TC chemotherapy and is acceptably tolerated. Given the small sample size and absence of a control group, these findings need confirmation in larger studies. The status of this method in clinical guidelines should be checked separately.
Limitations
Limitations include the small sample size (20 evaluable patients), the single-centre design, the absence of a control group and patients' own choice to use the cold cap (possible selection bias). Hair loss was assessed by a single physician and partly based on patient self-report. Follow-up time also varied from 3 weeks to 3 months after the end of chemotherapy.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.