Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

Abstract

Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

Hair safe study: Effects of scalp cooling on hair preservation and hair regrowth in breast cancer patients receiving chemotherapy - A prospective interventional study

“…However, the most important influence is the chemotherapeutic agent. In accordance with previously published studies [ 9 , [12] , [13] , [14] ], we observed that SC was more effective in patients receiving taxane monotherapy than in patients receiving an anthracycline-taxane-based regimen. Using the patients’ evaluation, 50% of patients with taxane monotherapy had grade 1 alopecia compared to 17.2% of patients with an anthracycline-taxane-based regimen.…”

“…The subjective patient self-evaluation may be influenced by the medical education on SC that patients received, knowing that hair loss was more likely to happen in an anthracycline-taxane-based regimen. The primary reason for discontinuation of SC was hair loss, which is consistent with other studies where hair loss was also the main reason for SC discontinuation [ 7 , 12 , 25 ].…”

“…This study additionally examined the potentially positive effect of SC on regrowth after chemotherapy-induced alopecia. To date, only a few studies have observed hair regrowth after CT [ 6 , 7 , 10 , 12 ]. Although the exact mechanism by which SC prevents alopecia is not yet fully understood, SC presumably leads to protection of the hair follicle.…”

“…Initial studies on SC were conducted primarily with taxane- and only rarely anthracycline-based chemotherapy [ 9 ]. A high efficacy of SC was previously demonstrated for chemotherapy containing taxanes only; however, this does not reflect clinical reality considering that most chemotherapy regimens contain two or more cytostatic agents [ 9 , [12] , [13] , [14] ].…”

Einfluss von Scalp Cooling auf Regrowth nach Chemotherapie-induzierter Alopezie

“…Aktuell ist das Scalp Cooling (SC) eine vielversprechende Methode, um CIA zu verhindern 3 4 5 6 . Diesbezüglich gibt es bereits zahlreiche Veröffentlichungen, jedoch wurde der Einfluss der Kopfhautkühlung auf das Regrowth erst in wenigen Publikationen beschrieben 1 3 7 . Ziel der Hair-Safe Studie war es neben der Effektivität des SC im klinischen Alltag auch den Einfluss des SC auf das Regrowth der Haare nach CIA zu analysieren.…”