The efficacy of PAXMAN scalp cooling system in preventing hair loss of breast cancer patients receiving chemotherapy in Western India

Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients.

This is a multi-centre, retrospective-observational study including patients registered from 1^st March, 2019 to 30^th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy.

A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR 44 – 62). The prevention of alopecia (Grade 0 & Grade I) was seen in 81% while more than 50% hair loss (Grade 2) was seen in 16.48% after completion of treatment. The univariate analysis shows that the CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04- 6.958; p=0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295- 30.787; p=0.001). The incidence of Grade 2 (> 50% hair loss) alopecia was 81.3% in patients < 6 weeks and was 18.8% at > 6 weeks of the start of chemotherapy (p<0.0001). No adverse events were reported in 71.4 % of patients and the most common adverse event was headache (18.7%).