title: Sensor-controlled scalp cooling to prevent chemotherapy-induced alopecia in female cancer patients.
abstract: BACKGROUND
  Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cooling systems demonstrate varying results in terms of effectiveness and tolerability.
  
  
  METHODS
  For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (who) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy.
  
  
  RESULTS
  Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel-carboplatin experienced less alopecia. The compound successful outcome ("no head covering" plus "who grade 0/1") was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel-cyclophosphamide or 6 cycles of paclitaxel-carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel-doxorubicin-cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil-epirubicin-cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin-cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens.
  
  
  CONCLUSIONS
  The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the patient. Use of a compound endpoint with subjective and objective measures provides insightful and practical information when counselling patients.
authors.affiliation: Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland.
authors.forename: M K
authors.initials: MK
authors.lastname: Fehr
authors.affiliation: Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Welter
authors.affiliation: Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland.
authors.forename: W
authors.initials: W
authors.lastname: Sell
authors.affiliation: Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, Clinic of Kempten-Oberallgäu, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Felberbaum
keywords: Chemotherapy-induced alopecia; breast cancer; ovarian cancer; sensor-controlled scalp cooling