Description
Introduction: Scalp cooling has become an increasingly
effective method in reducing chemotherapy-induced alopecia.
However, debate exists over its effectiveness, tolerance and
side-effects due to considerable variation in success rates,
multiple methodological discrepancies and wide variety of
chemotherapy regimens used. This study aims to assess
retrospectively, the effectiveness, side-effects and tolerability of
scalp cooling in breast cancer patients treated at the Norfolk
and Norwich University Hospital (NNUH).
Methods: There were two parts to this study. Firstly, a
review of electronic health records to ascertain an objective
assessment of the severity of alopecia using the National Cancer
Institute (NCI) Common Toxicity Criteria (CTC v2.0) .
Secondly, a patient-centered assessment using a postal
questionnaire designed to obtain subjective information on the
effectiveness of scalp cooling, its side-effects and tolerability.
194 patients with breast cancer referred to the Oncology
Department at the NNUH between 1st January 2006 and
31st December 2008 were identified. 60 patients were
included in the final analysis. All were female, median age
range 50.8 years.
Results: We identified there was no documentation in
terms of the severity of alopecia being evaluated objectively after
receiving at least 2 cycles of chemotherapy treatment in all 60
cases. As a subjective assessment no patients (0%) described
achieving no hair loss (Grade 0) with scalp cooling. 35
patients (58.3%) described hair loss as mild (Grade 1) whilst
25 patients (41.7%) reported complete hair loss (Grade 2). In
71.6% of patients headaches were tolerable, 24 out of 50
(48%) who reported a sensation of feeling cold continued using
scalp cooling for all six cycles of chemotherapy and 21 patients
(35%) experienced scalp pain.
Conclusion: We can conclude scalp cooling provides a
valuable means in minimising chemotherapy-induced hair
loss particularly in patients with breast cancer in adjuvant
setting. Overall, scalp cooling is a safe and reasonably well
tolerated procedure which is effective in more than 50% of the
patients in our cohort.
