Efficacy of Scalp Cooling in Preventing Chemotherapy-Induced Alopecia in Breast Cancer Patients Receiving Adjuvant Docetaxel and Cyclophosphamide Chemotherapy.
BACKGROUND
Chemotherapy-induced alopecia (CIA) is a distressing adverse effect of many chemotherapy agents. The TC (docetaxel [Taxotere] and cyclophosphamide) chemotherapy regimen is typically associated with complete alopecia. Scalp cooling with cold caps has been reported to minimize or prevent CIA. We conducted a prospective study to assess efficacy of scalp cooling in preventing CIA among women receiving adjuvant TC chemotherapy for breast cancer.


METHODS
Women at the Weill Cornell Breast Center who independently elected to use scalp cooling with cold caps during adjuvant TC chemotherapy were asked to participate. Degree of hair loss was assessed by a single practitioner using Dean's alopecia scale (grade 1/excellent [< 25% hair loss], grade 2/good [25%-50% hair loss], grade 3/moderate [50%-75% hair loss], grade 4/poor [> 75% hair loss]), by digital photographs, and by patient self-report of hair thinning or the need to wear a wig/head covering, or both. Assessments were made before each chemotherapy treatment and at follow-up visits between 3 weeks and 3 months after completion of chemotherapy.


RESULTS
Of 20 evaluable patients, 10% reported a need to wear a wig/head covering at the follow-up visit. Dean's alopecia score was excellent for 65% of patients, good for 25% of patients, and moderate or poor for 10% of patients. The majority of patients reported hair thinning after every chemotherapy cycle. No patient discontinued therapy because of an intolerance to cold caps.


CONCLUSIONS
Scalp cooling with cold caps appears to be effective in preventing CIA among the majority of women undergoing treatment with TC chemotherapy.
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY. Electronic address: tec9002@med.cornell.edu.
Tessa
T
Cigler
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Devora
D
Isseroff
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Barbara
B
Fiederlein
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Sarah
S
Schneider
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Ellen
E
Chuang
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Linda
L
Vahdat
Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Anne
A
Moore
D000328:Adult; D000505:Alopecia / Q000139:chemically induced* / Q000517:prevention & control*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D005500:Follow-Up Studies; D006197:Hair / Q000254:growth & development; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012535:Scalp; D043823:Taxoids / Q000009:adverse effects; D016896:Treatment Outcome
D043823:Taxoids; D000077143:Docetaxel; D003520:Cyclophosphamide
Alopecia; Breast cancer; Chemotherapy; Cold cap; Cryotherapy