Scalp Hypothermia Research Articles

Therapeutic Effect of Superficial Scalp Hypothermia on Chemotherapy-Induced Alopecia in Breast Cancer Survivors.

Alopecia is a common adverse effect of neoadjuvant or adjuvant chemotherapy in patients with early breast cancer. While hair typically regrows over time, more than 40% of patients continue to suffer from permanent partial alopecia, significantly affecting body image, psychological well-being, and quality of life. This concern is a recognized reason why some breast cancer patients decline life-saving chemotherapy. It is critical for healthcare professionals to consider the impact of this distressing side effect and adopt supportive measures to mitigate it. Among the various strategies investigated to reduce chemotherapy-induced alopecia (CIA), scalp cooling has emerged as the most effective. This article reviews the pathophysiology of CIA and examines the efficacy of different scalp cooling methods. Scalp cooling has been shown to reduce the incidence of CIA, defined as less than 50% hair loss, by 50% in patients receiving chemotherapy. It is associated with high patient satisfaction and does not significantly increase the risk of scalp metastasis or compromise overall survival. Promising new scalp cooling technologies, such as cryogenic nitrogen oxide cryotherapy, offer the potential to achieve and maintain lower scalp temperatures, potentially enhancing therapeutic effects. Further investigation into these approaches is warranted. Research on CIA is hindered by significant heterogeneity and the lack of standardised methods for assessing hair loss. To advance the field, further interdisciplinary research is crucial to develop preclinical models of CIA, establish a uniform, internationally accepted and standardised classification system, and establish an objective, personalised prognosis monitoring system.

Alopecia prevention during chemotherapy: from the benchmark to real clinical practice. A prospective study

Background. Alopecia is one of the main side effects of anticancer chemotherapy and has a significant impact on patients’ appearance, quality of life, social adaptation and mental health of cancer patients. Estimated number of new cancer diagnosis increases annually alongside with the proportion of patients receiving chemotherapy. That means an annual increase in the global burden of chemo-induced alopecia and associated negative consequences. The development of various methods for the prevention of alopecia in cancer patients has continued for decades. However, convincing data have been obtained only for the scalp hypothermia method. In this point, the Paxman company’s cooling systems (UK) – the Orbis and Orbis II devices – have been most widely studied. Despite the fact that Orbis devices were approved in Russia more than 10 years ago, since then just a small amount of real clinical practice has been accumulated and questions regarding the effectiveness of scalp hypothermia in patients with variable cancers still remain open.
 Aim. Analysis of local clinical practice with scalp hypothermia via the Orbis II device for the prevention of alopecia in patients receiving various chemotherapy regimens.
 Materials and methods. An open, prospective, single-center study included patients with various cancer types who were indicated for chemotherapy. Orbis II device was used for prophylactic hypothermia. The severity of alopecia was assessed according to the CTCAE version 5.0 at baseline and during anticancer therapy.
 Results. From June 2022 to May 2023, scalp cooling procedures were performed in 51 patients, of them 78% of all procedures were performed in female cancers: breast tumors – 109 (52.2%) procedures, ovarian cancer– 33 (15.8%), and cervix cancer – 22 (10.5%). The effectiveness of scalp hypothermia in preventing of severe alopecia was 73%.
 Conclusion. Scalp cooling can be considered as an effective method for the prevention of chemotherapy induced alopecia. Further studies are needed to assess larger patient populations to identify favorable and negative factors that affect potency of the hypothermia.

Scalp hypothermia for the prevention of chemotherapy-induced alopecia in breast cancer

Background. Breast cancer (BC) is a socially significant disease in women all over the world, ranking 1st in the structure and 5th in the number of deaths. Polychemotherapy in the complex treatment of BC accounts for approximately 80%. The main side effect that significantly affects the quality of life is alopecia, which occurs on average in 65% of patients.
 Aim. To evaluate the efficacy and tolerability of scalp hypothermia (SHT) for the prevention of chemotherapy-induced alopecia in patients with BC.
 Materials and methods. From June 2016 to September 2023, 75 patients with a median age of 44.1 years with stage I–IV BC were observed. All patients received cytotoxic therapy at various stages of treatment. To prevent alopecia, local SHT was used using an Orbis II device (Paxman Coolers, United Kingdom).
 Results. Stage I of the disease was observed in 18 (24%) patients, stage II in 22 (29.3%), stage III in 30 (40%), and stage IV in 5 (6.7%). Patients received 5 different neo- and adjuvant regimens of polychemotherapy. Taxane-containing combined regimens prevailed. 364 SHT sessions (4–8 sessions per patient) were performed; 48 (64%) patients received the procedure in full. Complete hair preservation was achieved in 43 (57.3%) patients. Grade 1 alopecia was observed in 19 (25.4%) patients and grade 2 in 9 (12%) patients. Of the 5 patients with advanced BC, grade 2 alopecia was reported in 1 patient, grade 3 in 3, and grade 4 in 1. Side effects were reported in 16% of cases; the most common were a feeling of cold and a slight headache. Due to the intolerance of the cold helmet, 3 patients refused to use it. No scalp metastases were observed during the follow-up. During the procedure, almost all patients noted a high level of comfort.
 Conclusion. Local SHT is an effective method of preventing cytotoxic therapy-induced alopecia in patients with BC. It improves the psychological and social adaptation of patients.

Scalp cooling and chemotherapy: evaluation of quality of life and trichoscopy

Objectives: This study aimed to evaluate the quality of life (QoL) of patients undergoing scalp cooling during chemotherapy and to describe hair density data assessed by trichoscopy. Background: Hair loss during chemotherapy is a common and distressing side effect, and prevention can be done through scalp hypothermia. Methods: A prospective cohort study was conducted at a single oncology center in Brazil. Patients undergoing scalp cooling during chemotherapy were included. QoL and body image satisfaction (BIS) questionnaires were administered at the beginning and end of treatment. Data on alopecia were collected. Trichoscopy with a Fotofinder® device was performed at the beginning, before the second cycle, and at the end of treatment. STROBE guidelines were followed for the development of this study. Results: Twenty-seven patients were included. There was no difference in mean QoL or BIS scores in the comparison of patients with hair loss < 50% with those with hair loss ≥ 50%. Better outcomes in the QoL and BIS scales were found in patients treated with anthracyclines. Hair density described by trichoscopy showed a maximum reduction of up to 16.3%, and loss was more common in the frontal area. Conclusions: Thus, there is no clear evidence of better QoL in patients with a lower grade of alopecia after scalp cooling during chemotherapy. Validated scales can be useful for assessing QoL in this population.

Role of scalp hypothermia in patients undergoing minimally invasive evacuation of hypertensive cerebral hemorrhage.

Objective:Hypertensive intracerebral hemorrhage (HICH) is one of the common multiple diseases in neurology. Patients with severe HICH have high risk of disability and poor prognosis.Methods:In order to explore the clinical effect of mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage in the treatment of severe HICH, 136 patients with severe HICH were selected and divided into control group and study group using random number table method, 68 each group. The control group was treated with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment, while the study group was treated with mild hypothermia combined with micro-traumatic evacuation of cerebral hemorrhage on the basis of conventional symptomatic treatment. After treatment, the two groups were followed up for eight weeks.Results:The overall effective rate, residual hematoma volume, rebleeding rate, National Institute of Health stroke scale (NIHSS) score, Barthel index score and incidence of adverse reactions after treatment were observed and compared. The overall effective rate of the study group was 89.7%, which was significantly higher than that of the control group (67.6%). The mortality rate of the study group was 3.0%, which was significantly lower than that of the control group (14.7%, P<0.05). The residual hematoma volume and rebleeding rate of the study group were significantly lower than those of the control group (P<0.05). Before treatment, the NIHSS score and Barthel index score of the two groups had no significant differences (P>0.05). After treatment, they were improved, and the improvement of the study group was more significant (P<0.05). The incidence of adverse reactions in the study group was 10.0%, which was significantly lower than that in the control group (36.0%, P<0.05).Conclusion:Mild hypothermia in combination with micro-traumatic evacuation of cerebral hemorrhage has significant clinical effect in the treatment of severe HICH. It can significantly improve neurological function and quality of life, causing few adverse reactions. Its clinical application value is high.

441P - The efficacy of scalp-cooling system for the prevention of chemotherapy-induced hair loss in metastatic breast cancer patients treated with eribulin

Background: Scalp cooling techniques have been applied to prevent or at least reduce chemotherapy-induced alopecia (CIA) since the 1970s. I had the opportunity to exploit the computer-controlled chilled helmet-like silicon cap system (RV-01) and to apply it to more than 300 breast cancer patients in my breast clinic. Recently the effectiveness of scalp-cooling system has been announced in cases of adjuvant chemotherapy. This report may be the first with results about the efficacy of this device for the prevention of CIA for metastatic breast cancer patients treated with eribulin. Methods: The RV-01 employs a digitized system for controlled scalp cooling by an integrated refrigerator in a control unit, in turn connected with a soft and tight-fitting silicon cap. 20 patients with metastatic breast cancer in our clinic were recruited and evaluated for CIA with or without scalp cooling. Four months after commencing chemotherapy including eribulin, their CIA were classified by Dean's grade scale and NCI-CTS grade sale. 16 patients were treated using RV-01 and 4 patients without. Mean age of using RV-01 and without 53.9 (range 45-65) years and 65.0 (range 43-77) years old, respectively. Results: None of the 16 patients using RV-01 treated with regimens including eribulin ever used a wig. Hair loss in these patients ranged from G-0 to G-1 by NCI-CTC scale and G-0 to G-3 by Dean’s scale. Discomfort such as headache, being chilled, and scalp pain were also assessed but scalp cooling was very well tolerated. In our development, we elaborated the use of inner cap made by non-woven fabric which should be considered significantly comfortable with respect to other types of caps. Conclusions: In our experience, scalp hypothermia is one approach that can be used to prevent hair loss for metastatic breast cancer patients treated with eribulin in spite of previously undergoing other chemotherapy. This device is simple to use and enables continuous and stable maintenance of temperature on the scalp. Not only does RV-01 system promote QOL of patients as a safe tool for hair loss prevention in cancer treatment, but it may contribute to better treatment as well. Legal entity responsible for the study: Kato Breast Surgery Clinic. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.

Thermal modelling of controlled scalp hypothermia using a thermoelectric cooling cap

This study presents a novel, thermoelectric cryotherapy cap that aims to provide effective and controlled scalp cooling to prevent hair loss for chemotherapy patients. The cap's design consists of multiple thermoelectric coolers (TECs) evenly spaced and bonded to a soft thermal interface material, tightly fitted to a patient's head. A numerical model is developed to assess the performance of alternative cap designs in relation to their ability to achieve hair follicle hypothermia. Under ideal conditions, 26.5 W of heat removal from the scalp is required to achieve the clinically-significant follicle temperature target of 22 °C. Temperature maps of the subcutaneous tissue are generated to visualise the development of hypothermic follicles, and thereby assess the effectiveness of the cap design. Transient studies show that cooling to the therapeutic temperature can be achieved within 40 min. To avoid the possibility of cold-induced tissue damage, individual thermoelectric cooling modules should not be operated at a cooling flux beyond approximately 3175 W/m2. This may be achieved with 38 modules evenly spaced in a checkerboard arrangement, each providing 0.7 W of cooling to the scalp.

Scalp hypothermia as a preventative measure for chemotherapy-induced alopecia: a review of controlled clinical trials.

Chemotherapy-induced alopecia (CIA) is a temporary, yet psychologically devastating form of hair loss that affects 65% of patients receiving cancer chemotherapy. In the 1970s, scalp hypothermia was introduced as a preventative measure against the development of CIA. Numerous studies provide evidence for the effectiveness of scalp cooling to prevent CIA, although results varied because of differences in chemotherapy regimen, cooling technique, mode of administration and patient factors. However, many of the existing studies are uncontrolled or consist of small sample sizes, and data from randomized, randomized studies are limited. To date, no clear guidelines have been established for optimum scalp cooling use as a treatment modality and its efficacy remain unknown. Nonetheless, scalp cooling remains the most widely utilized method for the prevention of CIA, and in December 2015, the United States Food and Drug Administration (FDA) cleared the DigniCap® Scalp Cooling System (Dignitana AB, Sweden) for marketing and the Orbis from Paxman® Coolers Ltd. received clearance in 2017. This literature review is one of the first to provide up-to-date review and side-by-side comparisons of controlled and randomized clinical trials (CCTs and RCTs) evaluating scalp hypothermia for the prevention of CIA. Our analyses of CCTs and RCTs to date show that scalp hypothermia is effective in reducing the occurrence rate of CIA, by 2.7-fold in the CCTs and 3.9-fold in the RCTs. These results suggest that scalp hypothermia represents an effective preventative measure for CIA, and provide guidance for management of anticipated alopecia following chemotherapy and for future investigations.

Scalp Hypothermia for Preventing Alopecia During Chemotherapy. A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BackgroundAlopecia is a side effect of chemotherapy and affects a patient's quality of life. Cooling the scalp during chemotherapy might reduce alopecia. The objective of this systematic and meta-analysis was to examine the effects of scalp cooling on the end point of alopecia in randomized controlled trials. Materials and MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Electronic searches of databases were undertaken through February 2017. In addition other sources were searched. All languages were considered for evaluation. Data were collected and evaluated using a data collection form. Assessment of biases was undertaken using Cochrane methods. When studies could be combined, binary outcomes were evaluated using risk ratio assessment and continuous outcomes were assessed using mean difference (MD). Confidence intervals (CIs) were included and heterogeneity using the I2 statistic. Grading of Recommendations, Assessment, Development, and Evaluation assessments were also made. ResultsTen studies were included in the analysis comprised of 654 patients. Most were patients with breast cancer 432 patients [66%] mainly receiving anthracyclines. For the binary outcome of < 50% versus > 50% alopecia, the use of scalp cooling reduced relative risk (RR) of alopecia by 43% (RR, 0.57; 95% CI, 0.45-0.72; I2 = 11%; P < .00001). For ordinal outcomes (alopecia on a scale of 0-3), use of scalp cooling significantly reduced alopecia (MD, −0.80; 95% CI, −1.19 to −0.41; I2 = 0%; P < .0001). The quality of the evidence was graded as moderate. ConclusionThis systematic review and meta-analysis supports the use of scalp cooling to prevent alopecia in patients with solid tumors undergoing chemotherapy.

212 Scalp hypothermia as a preventive measure for chemotherapy-induced alopecia: A systematic review of the literature

212 Scalp hypothermia as a preventive measure for chemotherapy-induced alopecia: A systematic review of the literature

Simulation of scalp cooling by external devices for prevention of chemotherapy-induced alopecia

Hypothermia of the scalp tissue during chemotherapy treatment (scalp cooling) has been shown to reduce or prevent chemotherapy-induced hair loss. In this study, numerical models are developed to investigate the interaction between different types of external scalp cooling devices and the human scalp tissue. This work focuses on improving methods of modeling scalp cooling devices as it relates specifically to the prevention of chemotherapy-induced alopecia. First, the cooling power needed for any type of device to achieve therapeutic levels of scalp hypothermia is investigated. Subsequently, two types of scalp cooling devices are simulated: a pre-cooled/frozen cap design and a liquid-cooled cap design. For an average patient, simulations show that 38.5W of heat must be extracted from the scalp tissue for this therapy in order to cool the hair follicle to 22°C. In practice, the cooling power must be greater than this amount to account for thermal losses of the device. Simulations show that pre-cooled and liquid-cooled cap designs result in different tissue temperatures over the course of the procedure. However, it is the temperature of the coolant that largely determines the resulting tissue temperature. Simulations confirm that the thermal resistance of the hair/air layer has a large impact on the resulting tissue temperatures. The results should be correlated with experimental data as an effort to determine the optimal parameter choices for this model.

Clinical performance of the DigniCap system, a scalp hypothermia system, in preventing chemotherapy-induced alopecia.

9518 Background: Alopecia is an emotionally traumatic side effect for breast cancer (BC) patients (pts) undergoing adjuvant chemotherapy (CTX). The DigniCap System is the first scalp cooling system...

Safety and efficacy of scalp hypothermia to prevent chemotherapy-induced alopecia: A study of a scalp-cooling system used in breast cancer women in a Mexican public hospital.

e12021 Background: Hair loss is one of the side effects associated with chemotherapy treatments. It causes emotional disturbances and constantly reminds the patient of the disease. This study analyzed the effectiveness of scalp-cooling system for prevention of alopecia in breast cancer patients. Methods: The aim of this study was to examine the efficacy and safety of a scalp-cooling system to prevent chemotherapy-induced alopecia. 68 breast cancer patients receiving neo or adjuvant were included in a nonrandomized pilot study. The Dignicap system consists of a refrigerator unit and a control unit integrated into a mobile cabinet and connected to a tight-fitting cooling cap. Women accepting the scalp-cooling system were compared for alopecia against those who refused group of 68 patients similarly treated. Hair loss in the 136 study patients was evaluated by nurses using World Health Organization (WHO) criteria at each cycle of chemotherapy and photo documentation. Concomitantly, tolerance and side-effects were also recorded in 68 accepting patients. Results: Nurses' ratings indicated that hair loss frequency was constantly lower, at each cycle of chemotherapy, in study patients with scalp-cooling system ( n = 68) than in those without (n = 68).Differences between the two groups were statistically significant at cycles 1 and 4 ( P < 0.05). Scalp cooling was generally very well tolerated; only three of 68 patients discontinued use of the cold cap due to discomfort and no scalp metastasis was observed among the 68 accepting patients followed up. Conclusions: This study demonstrates that scalp cooling was an effective and safe method of protection against hair loss caused by chemotherapy. Its routine use as part of neo or adjuvant chemotherapy, especially in cancers with low prevalences of scalp metastasis, should be seriously considered and should be clinically evaluated in a randomized trial and in studies using other chemotherapy regimens to determine optimal temperatures and durations of cooling for maximal efficacy.

Treatment and prevention of chemotherapy-induced alopecia with PTH-CBD, a collagen-targeted parathyroid hormone analog, in a non-depilated mouse model

Alopecia is a psychologically devastating complication of chemotherapy for which there is currently no effective therapy. PTH-CBD is a collagen-targeted parathyroid hormone analog that has shown promise as a therapy for alopecia disorders. This study compared the efficacy of prophylactic versus therapeutic administration of PTH-CBD in chemotherapy-induced alopecia using a mouse model that mimics the cyclic chemotherapy dosing used clinically. C57BL/6J mice were treated with a single subcutaneous injection of PTH-CBD (320 mcg/kg) or vehicle control before or after hair loss developing from three courses of cyclophosphamide chemotherapy (50-150 mg/kg/week). Mice receiving chemotherapy alone developed hair loss and depigmentation over 6-12 months. Mice pretreated with PTH-CBD did not develop these changes and maintained a normal-appearing coat. Mice treated with PTH-CBD after development of hair loss showed a partial recovery. Observations of hair loss were confirmed quantitatively by gray scale analysis. Histological examination showed that in mice receiving chemotherapy alone, there were small, dystrophic hair follicles mostly in the catagen phase. Mice receiving PTH-CBD before chemotherapy showed a mix of normal-appearing telogen and anagen hair follicles with no evidence of dystrophy. Mice receiving PTH-CBD therapy after chemotherapy showed intermediate histological features. PTH-CBD was effective in both the prevention and the treatment of chemotherapy-induced alopecia in mice, but pretreatment appears to result in a better cosmetic outcome. PTH-CBD shows promise as an agent in the prevention of this complication of chemotherapy and improving the quality of life for cancer patients.

Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Dąbrowski T. Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature. Contemporary Oncology/Współczesna Onkologia. 2011;15(2):95-101. doi:10.5114/wo.2011.21813. APA Dąbrowski, T. (2011). Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature. Contemporary Oncology/Współczesna Onkologia, 15(2), 95-101. https://doi.org/10.5114/wo.2011.21813 Chicago Dąbrowski, Tomasz. 2011. "Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature". Contemporary Oncology/Współczesna Onkologia 15 (2): 95-101. doi:10.5114/wo.2011.21813. Harvard Dąbrowski, T. (2011). Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature. Contemporary Oncology/Współczesna Onkologia, 15(2), pp.95-101. https://doi.org/10.5114/wo.2011.21813 MLA Dąbrowski, Tomasz. "Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature." Contemporary Oncology/Współczesna Onkologia, vol. 15, no. 2, 2011, pp. 95-101. doi:10.5114/wo.2011.21813. Vancouver Dąbrowski T. Hair loss as a consequence of cancer chemotherapy – physical methods of prevention. A review of the literature. Contemporary Oncology/Współczesna Onkologia. 2011;15(2):95-101. doi:10.5114/wo.2011.21813.

Scalp-cooling by DIGNICAP system for the prevention of chemotherapy-induced hair loss in breast cancer patients.

e11034 Background: The DigniCap system (Dignitana AB, Sweden) is an established, highly effective and safe device to prevent hair loss by cooling the scalp. This study evaluates the DigniCap system and presents the results of scalp hypothermia on breast cancer patients undergoing chemotherapy. Methods: DigniCap is using a digitized system for controlled scalp-cooling with a refrigerator integrated into a control unit with the soft and tight-fitting silicon cap. Scalp temperature was maintained at +5 centigrades throughout drug administration and for at least 30 min after discontinuing the infusion. Photographs of each patient's scalp were taken before starting chemotherapy. The evaluation was made using a visual analogue scale. All patients answered a questionnaire with 15 questions regarding physical and psychological issues. Results: From August 2007 to October 2009, 255 patients, aged 25-77 yrs (mean 47.4), with breast cancer were examined completely. The patients were treated with either paclitaxel (6...

Scalp Hypothermia Minimizes Alopecia in Breast Cancer Patients Receiving Non-Anthracycline Adjuvant Chemotherapy.

Abstract Background: Chemotherapy induced alopecia (CIA) is considered the most distressing side effect of chemotherapy for breast cancer patients. Scalp hypothermia offers hope to minimize chemotherapy induced alopecia (CIA) for breast cancer patients. We present data from a pilot study of scalp hypothermia with the Penguin Cold Cap System™ in patients receiving a combination chemotherapy regimen. Patients and Methods: Stage I-IIIC breast cancer patients, receiving adjuvant chemotherapy regimens with or without (A) were consented. Standard dose regimens included doxorubicin-cyclophosphamide (AC) x 4 cycles, dose dense, doxorubicin-cyclophosphamide followed by taxol (AC-T) x 8 cycles, taxotere-doxorubicin-cyclophosphamide (TAC) x 6 cycles, taxotere-cyclophosphamide (TC) x 4 cycles and taxotere-carboplatnium-trastuzumab (TCH) x 6 cycles. Photos were taken before and with each cycle and 3 weeks post chemotherapy, Dean's alopecia scale was used for grading. Caps were cooled to 8oC. Caps 1-2 were 20 minutes each prior to infusion, following caps were changed q 30 minutes throughout chemotherapy and for 3 hours post-chemotherapy. Results: See tables 1 and 2 for patient data. We enrolled 34 patients (22 (A) containing; 12 non (A) containing) after informed consent. Of patients withdrawn, 1 patient (AC-T) had metastatic disease at the time of registration and did not start scalp hypothermia,1 patient (TC) had scalp discoloration; 2 patients (AC and TAC) withdrew due to discomfort of cooling; 1 patient (TC) withdrew prior to start of therapy due to fear of discomfort and 1 patient (AC) was withdrawn for coloring hair at time of treatment. The mean percent of CIA in the (A) containing group was 52% (SD: 17 CI: 40-70) and the mean percent CIA in non (A) containing group was 25% (SD: 36 CI: 5-100). A comparison of the means yielded a p-value of 0.0003 in favor of non (A) containing regimens. Of the 12 patients in the non (A) containing regimen 83% (3 TCH, 7 TC) did not require a prostheses and of the patients receiving an (A) containing regimen 47% (8 AC) did not require a prostheses. For those patients who completed scalp hypothermia through chemotherapy, the median CIA for TC and TCH combined was 10% hair loss (5,25) and for AC, AC-T and TAC combined was 50% hair loss (45,70). Discussion: All patients who received TAC or AC-T had grade 4 CIA and needed a hair prostheses. Most AC patients preserved some of their hair. Hair thinning was even and not patchy in this group and most had no need for prostheses. Patients in the TC or TCH group, who were able to complete the scalp hypothermia therapy, retained 90% or better, of their hair and there was no need for prostheses in these groups. We found the scalp hypothermia technique used here reduces hair loss in AC patients and offers the possibility of CIA prevention for women with breast cancer receiving TC or TCH.Table 1. Data for all enrolled patientsRegimenEnrolledWithdrewCompletedAC1028AC-T716TAC514TC927TCH3-3 Table 2. Deans alopecia scale for all enrolled patientsRegimenGrade1 Excellent &amp;lt;25%Grade 2 Good 25-50%Grade 3 Moderate 50-75%Grade 4 Poor &amp;gt;75%AC2422AC-T---7TAC---5TC7--2TCH3--- Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5040.

Prevention of chemotherapy induced alopecia with scalp hypothermia: An evaluation of the Penguin Cold Cap system

20716 Background: Methods of scalp cooling previously tested to prevent chemotherapy induced alopecia (CIA) have had variable efficacy. We present data from a pilot study of the Penguin Cold Cap system (PCC) (Medical Specialties of California) used to minimize CIA in breast cancer patients receiving a chemotherapy regimen with a combination of doxorubicin (A), cyclophosphamide (C), or taxane (T). Methods: Patients with a diagnosis of stage I-IIIC breast cancer, receiving a chemotherapy regimen containing A-C or T were recruited. The first 2 caps are placed 20 minutes each prior to infusion to begin scalp cooling process. Caps are changed every 30 minutes to maintain cooled scalp temperature throughout chemotherapy and for 3 hours after. Patients were given instructions on hair care and are followed during and 24 weeks post treatment. Grading was based on the World Health Organization and Dean’s grading scale for alopecia. Success was defined as no need for cosmetic devices (i.e. wig) due to CIA. Results: Of the 17 patients originally enrolled, 1 patient had metastatic disease and was withdrawn due to the possibility of scalp metastasis, 6 patients opted out of the study after cycle 1 due to time of treatment or beginning hair loss and 1 patient was removed from study for non-compliance. Of the 9 remaining patients, 5 were receiving a regimen containing AC, 2 received TAC, 1 received AC-T and 1 received CT. Four of the AC patients 4 had grade 2 alopecia 3 weeks post chemotherapy and 1 patient had grade 3–4 alopecia discontinuing treatment after cycle 2. TAC patients both had grade 3–4 alopecia after cycle 1. One patient received AC-T and had grade 2–3 alopecia after cycle 8, and 1 patient received CT with grade 2 alopecia after cycle 4. Conclusions: All patients experienced some hair loss above the ear on each side of the head, however it was minimal. The hair loss that was experienced for most patients was uniform and not patchy. Although the results of the preservation were variable, most patients who completed treatment (66%) had no need for a cosmetic device and the treatment was well tolerated. We found in this small study, the PCC system was most effective for treatment regimens containing AC; CT and somewhat effective in AC-T, however the PCC does not seem to be as effective in TAC. No significant financial relationships to disclose.

231 - Scalp hypothermia for 2 hours prevents alopecia after adriamycin based chemotherapy

231 - Scalp hypothermia for 2 hours prevents alopecia after adriamycin based chemotherapy

Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy.

To assess any difference in the incidence of alopecia during treatment and of skull metastases during follow-up among breast cancer patients undergoing scalp cooling during chemotherapy and those treated at ambient temperatures. A series of 35 breast cancer patients receiving adjuvant chemotherapy were consecutively assigned either to a scalp cooling regimen (19 patients) or to an ambient temperature regimen (16 patients). Hypothermia was administered with electrically cooled caps (SCS II: Amit Technology, Jerusalem) for 1 h after treatment. A significant difference (P = 0.014) was detected in the incidence of alopoecia: 48% (9 patients) of those who had undergone cooling suffered alopoecia, while 81% (13 patients) of the group who had not undergone cooling lost scalp hair. Patient comfort levels were high. Follow-up (median time 14 months) has disclosed no scalp metastases. The implementation of routine scalp hypothermia as part of adjuvant chemotherapy treatment, especially in cancers without tendencies to bone metastases, should be seriously considered.