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Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia

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Abstract

Purpose

The patient impact of chemotherapy-induced alopecia (CIA) is high. Scalp cooling is applied to reduce CIA. The potential optimum post-infusion cooling times (PICTs) are currently unknown.

Methods

Scalp cooling was applied in 53 patients receiving docetaxel chemotherapy with 90-min PICT (observational part). Also 15 non-scalp-cooled patients were included. If hair preservation was observed in >80 % of the patients, randomisation between 45 and 90-min PICT was planned. Patients reported tolerance of scalp cooling and use of head covering.

Results

Observational study: 81 % of scalp-cooled patients did not require head covering versus 27 % of non-scalp-cooled patients. Randomised study: 79 % of 38 patients with 90-min PICT did not need head covering versus 95 % of 38 patients with 45-min PICT (p = 0.04). Scalp cooling was very well tolerated (visual analogue scale = 79).

Conclusion

A 45-min PICT can be recommended in 3-weekly docetaxel regimens with a dose of 75 or 100 mg/m2, administered in 60 min. The shorter PICT is a major advantage in time investment for patients. Patients (women and men) who receive docetaxel, except combined with doxorubicin and cyclophosphamide (taxotere, adriamycin and cyclophosphamide (TAC)) should be informed about the protective effect and high tolerability of scalp cooling in avoiding CIA.

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Acknowledgments

Special thanks go to all patients who participated in the study, to A. Willemse who assisted in data collection, to M. Peerbooms who assisted in data entry and to W. Peters, MD., of Catharina Hospital Eindhoven, who was willing to function as an independent advisor and to answer patients’ questions. Furthermore, we would like to thank the nurses and doctors who performed the study in the following hospitals: Medisch Centrum Alkmaar, Alkmaar; Tergooiziekenhuizen, Blaricum; Máxima Medisch Centrum, Eindhoven; Elkerliek, Helmond; Jeroen Bosch, ’s-Hertogenbosch; Leids Universitair Medisch Centrum, Leiden; St. Antonius, Nieuwegein; St. Elisabeth, Tilburg; Twee Steden, Tilburg; and Diaconessen, Utrecht. This work was supported by Sanofi Aventis.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Research Department, Eindhoven Cancer Registry/Comprehensive Cancer Centre South, PO Box 231, 5600 AE, Eindhoven, The Netherlands

    C. J. G. van den Hurk & W. P. M. Breed

  2. Department of Clinical Oncology, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands

    C. J. G. van den Hurk & J. W. R. Nortier

Authors
  1. C. J. G. van den Hurk
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  2. W. P. M. Breed
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  3. J. W. R. Nortier
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Correspondence to C. J. G. van den Hurk.

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van den Hurk, C.J.G., Breed, W.P.M. & Nortier, J.W.R. Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia. Support Care Cancer 20, 3255–3260 (2012). https://doi.org/10.1007/s00520-012-1465-0

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  • DOI: https://doi.org/10.1007/s00520-012-1465-0

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