Original Article

Supportive Care in Cancer

, Volume 20, Issue 12, pp 3255-3260

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

  • C. J. G. van den HurkAffiliated withResearch Department, Eindhoven Cancer Registry/Comprehensive Cancer Centre SouthDepartment of Clinical Oncology, Leiden University Medical Centre Email author 
  • , W. P. M. BreedAffiliated withResearch Department, Eindhoven Cancer Registry/Comprehensive Cancer Centre South
  • , J. W. R. NortierAffiliated withDepartment of Clinical Oncology, Leiden University Medical Centre

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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.

Keywords

Scalp cooling Chemotherapy-induced alopecia Docetaxel Post-infusion cooling time Hair loss Supportive care