by Christine Brunner, Miriam Emmelheinz, Ricarda Kofler,
Samira Abdel Azim, Marlene Lehmann, Verena Wieser, Magdalena Ritter, Christian
Marth, Daniel Egle
The Breast: VOLUME 64, P50-55, AUGUST
01, 2022 (Published: April 29, 2022)
Breast cancer is the most common cancer in women worldwide.
When detected early, the chance of long-term survival can be as high as 90% due
to massive improvements in therapeutic options over the past decades.
A substantial proportion of patients with breast cancer
still receive chemotherapy as part of their treatment, which, however, has detrimental
side effects.
Among the most common toxicities are nausea, emesis,
premature menopause and hair loss.
Although chemotherapy-induced alopecia is not a
life-threatening side effect, it ranks amongst the most troublesome side
effects concerning the patients’ quality of life and body image.
Due to the high chance of a cure by improved systemic
therapy, quality of life (QoL) is becoming an increasingly important aspect.
Chemotherapy-induced alopecia also affects psychological well-being and has
been associated with depression.
Currently, the most promising method to prevent
chemotherapy-induced alopecia is scalp cooling (SC). To date, various studies
have reported its efficacy in small patient populations
SC leads to vasoconstriction, which inhibits cellular drug
uptake, furthermore, hypothermia reduces the metabolic rate of hair follicles,
finally lowering susceptibility to chemotherapy damage. Concerns that SC might
increase scalp metastases have limited its clinical use in the past. However, a
recent meta-analysis by Rugo et al. showed no association of scalp metastases
with SC.
Initial studies on SC were conducted primarily with taxane-
and only rarely anthracycline-based chemotherapy.
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.
This prospective study aims to evaluate the efficacy of SC
in different chemotherapy regimens and hair recovery in the follow-up period.
