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Scalp cooling for hair loss prevention in female Japanese breast cancer patients receiving (neo)adjuvant chemotherapy

Supportive Care in Cancer volume 29, pages 437–443 (2021)Cite this article

Abstract

Purpose

Scalp cooling during chemotherapy infusion has been recently reported to have moderate efficacy in the mitigation of chemotherapy-induced alopecia; however, there are few reports on Asian patients. We aimed to clarify the effects of scalp cooling in Japanese women.

Patients and methods

Female Japanese breast cancer patients who planned to receive (neo)adjuvant chemotherapy participated in this prospective study on the efficacy of scalp cooling using the Paxman Scalp Cooling System for alopecia prevention. The primary outcomes were the rates of patients with Grade 3 alopecia (defined as hair loss of > 50%) and the rates of patients who used a wig or hat to conceal hair loss 1 month after the last infusion of chemotherapy. The subjects were given a brief questionnaire regarding headaches, bad mood, fatigue, and chills shortly after each cooling.

Results

One hundred and forty-three patients participated in the study and used the cooling cap at least once. The mean and median ages of the subjects were 50.6 and 50, respectively (age range 28–76). One hundred and twenty-nine patients completed the planned chemotherapy of 4 to 8 cycles. Among them (7 patients were not evaluable), 74 patients (60.7%) had Grade 3 alopecia 1 month after chemotherapy. Of 80 patients who used the scalp cooling system throughout the planned chemotherapy (1 patient was not evaluable), 36 patients (45.6%) experienced Grade 3 alopecia.

Conclusion

The efficacy of scalp cooling during chemotherapy infusion for hair loss mitigation in Asian women is similar to that in Caucasian women.

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References

  1. Lemieux J, Maunsell E, Provencher L (2008) Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: a literature review. Psycho-Oncology 17:317–328

    Article  Google Scholar 

  2. Rugo HS, Voigt J (2018) Scalp hypothermia for preventing alopecia during chemotherapy. A systematic review and meta-analysis of randomized controlled trials. Clin Breast Cancer 18:19–28

    Article  Google Scholar 

  3. Nangia J, Wang T, Osborne C, Niravath P, Otte K, Papish S, Holmes F, Abraham J, Lacouture M, Courtright J, Paxman R, Rude M, Hilsenbeck S, Osborne CK, Rimawi M (2017) Effect of a scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer: the SCALP randomized clinical trial. JAMA 317:596–605

    Article  Google Scholar 

  4. Rugo HS, Klein P, Melin SA, Hurvitz SA, Melisko ME, Moore A, Park G, Mitchel J, Bågeman E, D’Agostino RB Jr, ver Hoeve ES, Esserman L, Cigler T (2017) Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer. JAMA 317:606–614

    Article  Google Scholar 

  5. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Article  Google Scholar 

  6. De Laurentiis M, Cancello G, D’Agostino D et al (2008) Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol 26:44–53

    Article  Google Scholar 

  7. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Peto R, Davies C, Godwin J et al (2012) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 379:432–444

    Article  Google Scholar 

  8. Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, Geyer CE Jr, Dees EC, Goetz MP, Olson JA Jr, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez Moreno HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW Jr (2018) Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med 379:111–121

    CAS  Article  Google Scholar 

  9. Katsimbri P, Bamias A, Pavlidis N (2000) Prevention of chemotherapy-induced alopecia using an effective scalp cooling system. Eur J Cancer 36:766–771

    CAS  Article  Google Scholar 

  10. Lemenager M, Lecomte S, Bonneterre ME, Bessa E, Dauba J, Bonneterre J (1997) Effectiveness of cold cap in the prevention of docetaxel-induced alopecia. Eur J Cancer 33:297–300

    CAS  Article  Google Scholar 

  11. Lemenager M, Genouville C, Bessa EH, Bonneterre J (1995) Docetaxel-induced alopecia can be prevented. Lancet 346:371–372

    CAS  Article  Google Scholar 

  12. Peck HJ, Mitchell H, Stewart AL (2000) Evaluating the efficacy of scalp cooling using the Penguin Cold Cap system to reduce alopecia in patients undergoing chemotherapy for breast cancer. Eur J Oncol Nurs 4:246–248

    CAS  Article  Google Scholar 

  13. Betticher DC, Delmore G, Breitenstein U, Anchisi S, Zimmerli-Schwab B, Müller A, von Moos R, Hügli-Dayer AM, Schefer H, Bodenmann S, Bühler V, Trueb RR (2013) Efficacy and tolerability of two scalp cooling systems for the prevention of alopecia associated with docetaxel treatment. Support Care Cancer 21:2565–2573

    Article  Google Scholar 

  14. Rugo HS, Melin SA, Voigt J (2017) Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis. Breast Cancer Res Treat 163:199–205

    Article  Google Scholar 

  15. van den Hurk CJ, Breed WP, Nortier JW (2012) Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia. Support Care Cancer 20:3255–3260

    Article  Google Scholar 

  16. Komen MM, Breed WP, Smorenburg CH et al (2016) Results of 20- versus 45-min post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia. Support Care Cancer 24:2735–2741

    Article  Google Scholar 

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Author information

Affiliations

  1. Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan

    Shozo Ohsumi, Sachiko Kiyoto, Mina Takahashi, Seiki Takashima, Kenjiro Aogi, Miwa Matsuda, Naomi Yamamura & Miyuki Doi

  2. Department of Breast Medical Oncology, Breast Oncology Center, Cancer Institute Hospital for JFCR, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan

    Fumikata Hara

Authors
  1. Shozo Ohsumi
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  2. Sachiko Kiyoto
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  3. Mina Takahashi
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  4. Fumikata Hara
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  5. Seiki Takashima
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  6. Kenjiro Aogi
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  7. Miwa Matsuda
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  8. Naomi Yamamura
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  9. Miyuki Doi
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Corresponding author

Correspondence to Shozo Ohsumi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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This study was registered to UMIN-CTR, numbered UMIN000017657, on June 1, 2015.

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Ohsumi, S., Kiyoto, S., Takahashi, M. et al. Scalp cooling for hair loss prevention in female Japanese breast cancer patients receiving (neo)adjuvant chemotherapy. Support Care Cancer 29, 437–443 (2021). https://doi.org/10.1007/s00520-020-05506-w

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  • DOI: https://doi.org/10.1007/s00520-020-05506-w

Keywords

  • Scalp cooling
  • Hair loss prevention
  • Breast cancer
  • Asian women
  • Chemotherapy