title: Efficacy and tolerability of two scalp cooling systems for the prevention of alopecia associated with docetaxel treatment.
abstract: OBJECTIVE
  Chemotherapy-induced alopecia is very distressing for a patient and may have an impact on treatment decisions. On docetaxel-based therapy, alopecia occurs in a substantial proportion of patients. We aimed to investigate whether two different methods of scalp cooling can prevent hair loss.
  
  
  METHODS
  In this open-label, prospective, nonrandomized trial, patients with solid tumors receiving docetaxel in a palliative setting were allocated according to patients' preference to short-term cooling (over 45 min postinfusion) with a Paxman PSC-2 machine (PAX), with cold cap (CC), or no cooling. The combined endpoint was alopecia World Health Organisation (WHO) III or IV or the necessity to wear a wig. Study identifier is Clinicaltrials.gov NCT01008774.
  
  
  RESULTS
  Two hundred thirty-eight patients were included in the trial (128 patients PAX, 71 CC, and 39 no cooling). Number of cycles (median 4) and median docetaxel doses were similar across groups (55-60 mg/day on weekly therapy, 135-140 mg/day on 3-weekly therapy). Alopecia occurred with PAX, CC, and no cooling under 3-weekly docetaxel in 23, 27, and 74% and under weekly docetaxel in 7, 8, and 17%, respectively. Overall, cooling (PAX and CC combined) reduced risk of alopecia by 78% (hazard ratio 0.22; 95% confidence interval 0.12 to 0.41). CC and PAX prophylaxis led to the same degree of prevention of alopecia. Adverse events (AE) were reported in 5% (most frequently, sensation of cold), and 30 patients (13%) discontinued cooling measures after cycle 1.
  
  
  CONCLUSIONS
  In this first comparison published to date, both PAX and CC offer efficacious protection against hair loss, in particular when docetaxel is administered in a 3-weekly interval.
authors: Clinics of Medical Oncology, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland. dc.betticher@bluewin.ch
authors: Daniel C
authors: DC
authors: Betticher
authors: Geoffrey
authors: G
authors: Delmore
authors: Urs
authors: U
authors: Breitenstein
authors: Sandro
authors: S
authors: Anchisi
authors: Beatrice
authors: B
authors: Zimmerli-Schwab
authors: Andreas
authors: A
authors: Müller
authors: Roger
authors: R
authors: von Moos
authors: Anne Marguerite
authors: AM
authors: Hügli-Dayer
authors: Hubert
authors: H
authors: Schefer
authors: Sereina
authors: S
authors: Bodenmann
authors: Vera
authors: V
authors: Bühler
authors: Ralph R
authors: RR
authors: Trueb
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced* / Q000517:prevention & control*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D000077143:Docetaxel; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000517:prevention & control; D010166:Palliative Care / Q000379:methods; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D012535:Scalp; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D043823:Taxoids; D000077143:Docetaxel
references: Support Care Cancer. 1997 Mar;5(2):136-8
references: 9069614
references: J Am Acad Dermatol. 1996 Jul;35(1):74-8
references: 8682968
references: Crit Rev Oncol Hematol. 2003 Sep;47(3):213-35
references: 12962897
references: Scand J Clin Lab Invest. 1985 Oct;45(6):505-8
references: 4070952
references: Support Care Cancer. 2004 Aug;12(8):543-9
references: 15221580
references: J Epidemiol Community Health. 2004 Aug;58(8):635-41
references: 15252064
references: Acta Oncol. 2012 Apr;51(4):497-504
references: 22304489
references: Science. 2001 Jan 5;291(5501):134-7
references: 11141566
references: Oncol Nurs Forum. 1987 Nov-Dec;14(6):49-53
references: 3697290
references: Ann Oncol. 2005 Mar;16(3):352-8
references: 15642703
references: Eur J Cancer Care (Engl). 2003 Jun;12(2):154-61
references: 12787013
references: Am J Clin Oncol. 1982 Dec;5(6):649-55
references: 7165009
references: Curr Opin Support Palliat Care. 2010 Dec;4(4):281-4
references: 21045702
references: Cancer Nurs. 1988 Jun;11(3):170-3
references: 3401852
references: Eur J Oncol Nurs. 2004 Jun;8(2):121-30
references: 15171971
references: Cancer. 1984 Jul 1;54(1):34-7
references: 6372986
references: Psychooncology. 2008 Apr;17(4):317-28
references: 17721909
references: Support Care Cancer. 2012 Dec;20(12):3255-60
references: 22539051
references: Tumori. 2010 Mar-Apr;96(2):271-5
references: 20572585
references: N Engl J Med. 1978 May 25;298(21):1204-5
references: 651958
references: Support Care Cancer. 2003 Jun;11(6):371-7
references: 12768403
references: Support Care Cancer. 2004 Jan;12(1):3-5
references: 14615930
references: Lancet. 1977 Jul 30;2(8031):253-4
references: 69866