Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia

Oncologist. 2013;18(7):885-91.
Type:
Systematic Review
PMID:
23650021
DOI:
10.1634/theoncologist.2012-0332
Authors:

Manon M C Komen1, Carolien H Smorenburg, Corina J G van den Hurk, Johan W R Nortier

Author Affiliations:

1Department of Internal Medicine and Medical Oncology, Medical Centre Alkmaar, Alkmaar, The Netherlands.

Abstract
Purpose

The success of scalp cooling in preventing or reducing chemotherapy-induced alopecia (CIA) is highly variable between patients and chemotherapy regimens. The outcome of hair preservation is often unpredictable and depends on various factors.

Methods

We performed a structured search of literature published from 1970 to February 2012 for articles that reported on factors influencing the effectiveness of scalp cooling to prevent CIA in patients with cancer.

Results

The literature search identified 192 reports, of which 32 studies were considered relevant. Randomized studies on scalp cooling are scarce and there is little information on the determinants of the result. The effectiveness of scalp cooling for hair preservation depends on dose and type of chemotherapy, with less favorable results at higher doses. Temperature seems to be an important determinant. Various studies suggest that a subcutaneous scalp temperature less than 22 °C is required for hair preservation.

Conclusion

The effectiveness of scalp cooling for hair preservation varies by chemotherapy type and dose, and probably by the degree and duration of cooling.

Keywords

Alopecia; Chemotherapy; Scalp cooling; Side effects.

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