Scalp cooling with Cool Cap can palliate or avoid alopecia of adverse event by chemotherapy for breast cancer

Abstract

Abstract Background Alopecia induced by standard chemotherapy gives deep grief to breast cancer patients. Even if the hair will grow again after chemotherapy, it needs more than one year to recover the natural hair status without using wig. We applied the scalp cooling system of Cool Cap for breast cancer patients during chemotherapy. It can avoid alopecia perfectly or decrease hair loss in our patients. One patient’s hair is growing during chemotheraphy after chemotherapy-induced alopecia (CIA) by the first regimen of weekly paclitaxel without Cool Cap. Methods Since December 2017, we have applied the scalp cooling system, PAXMAN Cool Cap, on ten breast cancer patients. The cooling cap is choiced its size and farmly compressed to the whole patient scalp. The whole scalp is evenly cooled to 20 centigrade. Pre-cooling time is 30 minutes. Scalp cooling is continued during the chemotherapy. And post-cooling time is 90 minutes. The chemotherapy regimens are standard as docetaxel, nab-paclitaxel, TC, and EC. All these regimens are supposed to give alopecia to almost all patients, without Cool Cap. Its effect is evaluated by the toxicity scale of WHO and the original scale of hair volume and patchy loss area. Results The regimens are applied docetaxel to ten patients, nab-paclitaxel to one patient, TC to two patient, and EC to 7 patients for early and metastatic breast cancer patients. The evaluation of alopecia was grade 0 on fourteen patients, grade 1 on four patients, and grade 2 on two patient. Two patients needed hair wig for hair loss. One patient with CIA has her hair growing during the second part of chemotherapy with Cool Cap. Headache was prevented by NSAID. All patients were satisfied with this application of Cool Cap. Conclusions The Cool Cap system is suprisingly effective to prevent CIA. It should be standard therapy for all breast cancer patients on chemotherapy.