Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

Shozo Ohsumi,Seiki Takashima,Sachie Shimizu,Sachiko Kiyoto,Kenjiro Aogi,Mina Takahashi,Miyuki Doi

doi:10.1007/s00520-021-06168-y

Abstract

PurposeScalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling.Patients and methodsOne hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades).ResultsOf 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B.ConclusionsScalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

Highlights

Breast cancer is the most common cancer in women worldwide [1]. (Neo)adjuvant chemotherapy is an important part of breast cancer treatment to improve the prognosis
Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients has become widespread in European and North American countries
We previously reported the results of alopecia mitigation by scalp cooling duringadjuvant chemotherapy with anthracyclines and/or taxanes for Japanese breast cancer patients in a prospective study, and demonstrated that scalp cooling reduced severe alopecia due to chemotherapy by half [3]

Summary

Introduction

Breast cancer is the most common cancer in women worldwide [1]. (Neo)adjuvant chemotherapy is an important part of breast cancer treatment to improve the prognosis. Breast cancer is the most common cancer in women worldwide [1]. (Neo)adjuvant chemotherapy is an important part of breast cancer treatment to improve the prognosis. The chemotherapeutic agents used in (neo)adjuvant chemotherapy for breast cancer almost always cause severe chemotherapy-induced alopecia, which distresses the patients [2]. Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients has become widespread in European and North American countries. We previously reported the results of alopecia mitigation by scalp cooling during (neo)adjuvant chemotherapy with anthracyclines and/or taxanes for Japanese breast cancer patients in a prospective study, and demonstrated that scalp cooling reduced severe alopecia due to chemotherapy by half [3]. Prospective studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective follow-up study of the 117 patients

Methods

Results

Conclusion