Scalp cooling device effective in reducing chemo-induced alopecia in breast cancer patients
Use of a scalp cooling device is effective in reducing alopecia or hair loss in patients with breast cancer who are undergoing neoadjuvant/adjuvant chemotherapy including anthracyclines* and taxanes**, according to studies presented at SABCS 2018.
A prospective analysis evaluated 118 women (median age 44 years) with early/locally advanced breast cancer sequentially treated with thrice-weekly docetaxel/cyclophosphamide, epirubicin 90 mg/m2, or cyclophosphamide 600 mg/m2, followed by 12 courses of weekly paclitaxel 80 mg/m2. Hair loss was estimated using the Dean scale*** by evaluating photographs of the head during and 1 month following chemotherapy. [SABCS 2018, abstract P1-11-03]
Treatment success (≤50 percent hair loss, Dean scale score of 0–2) was achieved in 87.3 percent of participants, 35.6 percent of whom reported no hair loss.
Toxicities reported were grade 1/2 headache (47.4 percent), cervical discomfort (30.5 percent), and skin pain (8.5 percent). The prime reason for discontinuing the use of the device was Dean scale G3 hair loss (12.7 percent), followed by discomfort (6.8 percent) and headache (3.4 percent).
Another prospective evaluation on 143 Japanese women (median age 50 years) with breast cancer who were receiving neoadjuvant chemotherapy generated similar results after 1 month. Of these, 129 completed a chemotherapy regimen of 4–8 cycles. The scalp cooling device was used 30 minutes prior to, during, and 90 minutes after each infusion. [SABCS 2018, abstract P4-16-13]
Those who continued to use the scalp cooling device throughout the planned course of chemotherapy had significantly lower rates of grade 3 alopecia (hair loss >50 percent) than those who discontinued the device by day 10 of cycle one (45.6 percent vs 89.3 percent; p=0.0001).
The findings support previous evidence showing the efficacy of scalp cooling among women undergoing a non-anthracycline based chemotherapy regimen for breast cancer.  Moreover, the current results may address other issues associated with scalp cooling, which has been reported to be dependent on factors such as the type of chemotherapy regimen, dosing, and schedule, as well as the type of scalp cooling device or system used. [Oncologist 2013;18:885-891; Ann Oncol 2005;16:352-358]
Taken together, the findings provide insight for breast cancer patients afflicted with or troubled by chemotherapy-induced alopecia, which is a common adverse effect that could be emotionally taxing for patients, said the researchers, noting that a successful scalp cooling regimen could improve patients’ treatment experience and quality of life, and mitigate feelings of disappointment regarding physical appearance.