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The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis

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Abstract

Purpose

To systematically assess the efficacy and side effects of scalp cooling in patients with breast cancer.

Methods

A systematic literature search was conducted in October 2020 across Cochrane Library, PubMed, Embase, CINAHL, Web of Science, Scopus, and four Chinese databases (CNKI, Wanfang, SinoMed, and VIP database). Our review included all randomized controlled trials, cohort studies, and cross-sectional studies. Two authors independently searched databases, screened studies, extracted data, and evaluated each included study’s methodological quality and risk bias. Meta-analysis was performed using Stata 15.1 software package and Revman 5.3 software, with estimates of scalp cooling effect and its side effects from pooled using a random-effects model. This study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020216224).

Results

In total, 755 articles were screened and data from 27 studies involving 2202 participants were used in the meta-analysis. Studies meeting inclusion and exclusion criteria were three randomized clinical trials, 12 cohort studies, and 12 cross-sectional studies. The effectiveness rate of using a scalp cooling device to protect hair was 61% (95% CI: 55 to 67%, I2 = 88%, P = 0.000). However, scalp cooling therapy’s side effects are not be ignored, such as headache, dizziness, scalp pain, neck pain, feeling cold, heaviness of the head, skin rash, nausea, and overtightened strap.

Conclusions

This review shows that scalp cooling devices can significantly improve the patients with breast cancer chemotherapy–induced alopecia, but the implications of its side effects provide guide for the implementation of this technology.

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Data availability

Not applicable; no person’s data.

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Code availability

Stata 15.1 software package (Stata Corp LP, College Station, TX, USA.) and Revman 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.)

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Authors and Affiliations

  1. Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China

    Shurui Wang & Ting Yang

  2. Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China

    Aomei Shen, Wanmin Qiang, Zihan Zhao & Fangyuan Zhang

Authors
  1. Shurui Wang
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  2. Ting Yang
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  3. Aomei Shen
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  4. Wanmin Qiang
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  6. Fangyuan Zhang
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Contributions

The conception and design of the review: all authors

Literature retrieval: SW, TY

Literature screening: SW, TY, AS

Quality assessment: SW, TY, AS

Data analysis: SW, WQ, ZZ, FZ

Writing—original draft: SW

Writing—review and editing: all authors

Corresponding author

Correspondence to Wanmin Qiang.

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As this is a systematic review reporting on existing data, ethics approval was not required.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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The authors are responsible for the correctness of the statements provided in the manuscript. There was no need to obtain permission from any person for publication of this review.

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The authors declare no competing interests.

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Wang, S., Yang, T., Shen, A. et al. The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer 29, 6943–6956 (2021). https://doi.org/10.1007/s00520-021-06188-8

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  • DOI: https://doi.org/10.1007/s00520-021-06188-8

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