Reducing Chemotherapy-Induced Alopecia

Chemotherapy-induced alopecia (CIA) is a common side effect of chemotherapy and reversible in most cases, but for some it can be permanent, particularly following curative adjuvant regimens. Scalp-cooling devices (SCDs) demonstrated efficacy in staving off the adverse social effect in response to a patient’s change in appearance, but data on their use are limited. A poster presented at the San Antonio Breast Cancer Symposium highlighted the results of a retrospective study on SCD use.

The study included 87 women and three men, most of whom (n=74) had breast cancer who were being treated at a single infusion center between June 2016 and May 2018. All patients were receiving adjuvant or neoadjuvant chemotherapy and used the Dignicap™ Cold-Cap with at least one treatment cycle. Caps had to be comfortable and fit appropriately; the researchers also established the following rules: hair was washed weekly with sulfate-free shampoo, dry shampoo was allowed, hair could not be cut or color-processed, powder color products were allowed, blow dryers were not permitted, hair was combed daily using only wide-tooth combs, and electric warming blankets were used during chemotherapy. Each patient was evaluated by the same nurse for objective hair loss before the first chemotherapy session and after the last one. For patients who did not use the SCDs for all cycles, they were graded upon their discontinuation. Patients were stratified into four chemotherapy regimen groups: taxane-based, anthracyclines only, combination of anthracyclines and taxane, and neither anthracyclines nor taxanes. A specially trained capper assisted patients during each session to appropriately fit and use the SCD.

A total of 29 patients received anthracyclines. In 86% of these cases, it was in combination with taxanes. After treatment completion, 18 of those patients (62%) had grade 1 alopecia after treatment. There were 36 compliant taxane-based patients who received SCD with each cycle; most of these patients (n=33; 92%) had grade 1 alopecia. Seven patients received neither anthracyclines nor taxanes, of whom none sustained a grade 2 alopecia.

The study authors suggested that the low rate of alopecia could perhaps be attributed to patient education on haircare between chemotherapy cycles, as well as capper use.