1. Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer
- Author
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Rugo, Hope S, Klein, Paula, Melin, Susan Anitra, Hurvitz, Sara A, Melisko, Michelle E, Moore, Anne, Park, Glen, Mitchel, Jules, Bågeman, Erika, D’Agostino, Ralph B, Hoeve, Elizabeth S Ver, Esserman, Laura, and Cigler, Tessa more...
- Subjects
Clinical Research ,Breast Cancer ,Cancer ,Clinical Trials and Supportive Activities ,Prevention ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Adult ,Aged ,Alopecia ,Anthracyclines ,Antineoplastic Combined Chemotherapy Protocols ,Breast Neoplasms ,Bridged-Ring Compounds ,Chemotherapy ,Adjuvant ,Female ,Headache ,Humans ,Hypothermia ,Induced ,Medical Illustration ,Middle Aged ,Neoadjuvant Therapy ,Photography ,Prospective Studies ,Quality of Life ,Scalp ,Taxoids ,Medical and Health Sciences ,General & Internal Medicine - Abstract
ImportanceChemotherapy-induced alopecia is a common and distressing adverse effect. In previous studies of scalp cooling to prevent chemotherapy-induced alopecia, conclusions have been limited.ObjectivesTo evaluate whether use of a scalp cooling system is associated with a lower amount of hair loss among women receiving specific chemotherapy regimens for early-stage breast cancer and to assess related changes in quality of life.Design, setting, and participantsA prospective cohort study conducted at 5 US medical centers of women with stage I or II breast cancer receiving adjuvant or neoadjuvant chemotherapy regimens excluding sequential or combination anthracycline and taxane (106 patients in the scalp cooling group and 16 in the control group; 14 matched by both age and chemotherapy regimen). The study was conducted between August 2013 and October 2014 with ongoing annual follow-up for 5 years.ExposuresUse of a scalp cooling system. Scalp cooling was initiated 30 minutes prior to each chemotherapy cycle, with scalp temperature maintained at 3°C (37°F) throughout chemotherapy and for 90 minutes to 120 minutes afterward.Main outcomes and measuresSelf-estimated hair loss using the Dean scale was assessed 4 weeks after the last dose of chemotherapy by unblinded patient review of 5 photographs. A Dean scale score of 0 to 2 (≤50% hair loss) was defined as treatment success. A positive association between scalp cooling and reduced risk of hair loss would be demonstrated if 50% or more of patients in the scalp cooling group achieved treatment success, with the lower bound of the 95% CI greater than 40% of the success proportion. Quality of life was assessed at baseline, at the start of the last chemotherapy cycle, and 1 month later. Median follow-up was 29.5 months.ResultsAmong the 122 patients in the study, the mean age was 53 years (range, 28-77 years); 77.0% were white, 9.0% were black, and 10.7% were Asian; and the mean duration of chemotherapy was 2.3 months (median, 2.1 months). No participants in the scalp cooling group received anthracyclines. Hair loss of 50% or less (Dean score of 0-2) was seen in 67 of 101 patients (66.3%; 95% CI, 56.2%-75.4%) evaluable for alopecia in the scalp cooling group vs 0 of 16 patients (0%) in the control group (P more...
- Published
- 2017