Introduction
Scalp cooling has been used to mitigate chemotherapy-induced alopecia (CIA), but few studies have been conducted in Asian patients. The purpose of this study is to evaluate the effectiveness of the Paxman cooling system in Japanese women with breast cancer undergoing (neo)adjuvant chemotherapy.
Target
To evaluate the efficacy and safety of the Paxman scalp cooling system in the prevention of alopecia in Japanese breast cancer patients.
Methods
This prospective study included 143 Japanese women with breast cancer who received (neo)adjuvant chemotherapy. Scalp cooling was performed 30 minutes before, during and 90 minutes after each chemotherapy infusion. The primary outcomes were the percentage of patients with grade 3 alopecia (more than 50% hair loss) and the use of a wig or cap one month after the last infusion. In addition, symptoms such as headache, fatigue and chills were assessed.
Results
Of the 143 patients, 122 completed chemotherapy. Of these, the 60.7% presented with grade 3 alopecia one month after treatment. Of the 79 patients who completed scalp cooling for the duration of chemotherapy, the 45.6% experienced grade 3 alopecia. In comparison, the 88.3% of patients who discontinued cooling early (usually after the first cycle) developed grade 3 alopecia.
Analysis
Scalp cooling significantly reduced the rate of alopecia in those patients who used it throughout treatment. The study also showed that the type of chemotherapy influences efficacy: taxane- and anthracycline-based regimens had better hair preservation results.
Scalp Cooling Effectiveness
The Paxman system showed moderate efficacy in preventing alopecia, with better results in patients who completed cooling treatment, especially those who received chemotherapy with taxane-based regimens.
Scalp Cooling Safety
The most common side effects were headaches, fatigue and chills, although these were mild in most cases. Some patients reported jaw pain due to the fit of the cooling cap.
Heterogeneity of the studies
The study did not include a control group, but the results of patients who discontinued cooling were used as a comparison. This may introduce some bias, although the results support the efficacy of cooling.
Quality of Life and Psychological Outcomes
Despite the positive results in mitigating hair loss, almost all patients (86.1%) wore a wig or cap one month after chemotherapy, suggesting strong social pressure regarding physical appearance.
Key Facts
- Alopecia Risk Reduction: The patients who completed the cooling had an alopecia rate of 45.6%, while those that discontinued it had a rate of 89.3%.
- Relative Risk (RR): The rate of alopecia was significantly lower in patients who completed cooling.
- Number of Participants: 143 patients participated in the study, of whom 122 were evaluable.
- Type of chemotherapy: The docetaxel and cycloposfamide (CT) regimens showed a greater degree of hair loss than the anthracycline- and taxane-based regimens.
- Adverse Events: Side effects included headaches, chills and fatigue, but were mostly mild and tolerable.
Conclusion
The Paxman scalp cooling system is moderately effective in preventing alopecia in Japanese breast cancer patients receiving chemotherapy.
Document Analysis Method
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