Ines Vasconcelos1, Alexandra Wiesske1, Winfried Schoenegg1
1Berlin oncology Center Kurfürstendamm, Kurfürstendamm 216, 10179 Berlin, Germany
A single-centre, prospective, observational study aimed to assess the success rates of scalp cooling in breast cancer patients undergoing chemotherapy. The 131 participants independently decided if they felt the need to wear a wig or head covering. The perceived percentage of hair loss was assessed by the oncology study nurse through an empirical visual evaluation.
Drug regimens: both anthracycline/taxane-based chemotherapy (74%) and taxane-monotherapy chemotherapy (26%) included.
Timing of chemotherapy: both neoadjuvant and adjuvant patients included.
Method of scalp cooling: Paxman Scalp Cooling System
93 participants (71%) had successful treatment, meaning they did not require a wig and retained over 50% of their hair. Table 1 shows the successes and failures. The degree of success varied greatly between chemotherapy regimens. 5 participants also received a carboplatin-anthracycline combination, however the small group size (n=5) impedes the analysis of success rates.
The participants rated the scalp cooling procedure as reasonably comfortable. This is reflected as only 9 participants (7%) discontinued the treatment due to adverse effects (headaches/ nausea/discomfort). Additional information: The fit of the cap was found to be very important. The nurses on site were highly trained in the fitting of the cap and used a wrapping technique to improve cap fit. Only appropriate candidates were selected for this trial. Patients were assessed on their baseline alopecia and given empirically based advice on success rates. This was to manage patient expectations, particularly as the cost of scalp cooling is not covered by health insurance in Germany.
This trial did not use standardised photographs when grading the hair loss, a control group was not recorded, and the patients were not randomised. The sample size was also relatively small.
