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- Title
Efficacy and tolerability of two scalp cooling systems for the prevention of alopecia associated with docetaxel treatment.
- Authors
Betticher, Daniel; Delmore, Geoffrey; Breitenstein, Urs; Anchisi, Sandro; Zimmerli-Schwab, Beatrice; Müller, Andreas; Moos, Roger; Hügli-Dayer, Anne; Schefer, Hubert; Bodenmann, Sereina; Bühler, Vera; Trueb, Ralph
- Abstract
Purpose: Chemotherapy-induced alopecia is very distressing for a patient and may have an impact on treatment decisions. On docetaxel-based therapy, alopecia occurs in a substantial proportion of patients. We aimed to investigate whether two different methods of scalp cooling can prevent hair loss. Methods: In this open-label, prospective, nonrandomized trial, patients with solid tumors receiving docetaxel in a palliative setting were allocated according to patients' preference to short-term cooling (over 45 min postinfusion) with a Paxman® PSC-2 machine (PAX), with cold cap (CC), or no cooling. The combined endpoint was alopecia World Health Organisation (WHO) III or IV or the necessity to wear a wig. Study identifier is Clinicaltrials.gov NCT01008774. Results: Two hundred thirty-eight patients were included in the trial (128 patients PAX, 71 CC, and 39 no cooling). Number of cycles (median 4) and median docetaxel doses were similar across groups (55-60 mg/day on weekly therapy, 135-140 mg/day on 3-weekly therapy). Alopecia occurred with PAX, CC, and no cooling under 3-weekly docetaxel in 23, 27, and 74 % and under weekly docetaxel in 7, 8, and 17 %, respectively. Overall, cooling (PAX and CC combined) reduced risk of alopecia by 78 % (hazard ratio 0.22; 95 % confidence interval 0.12 to 0.41). CC and PAX prophylaxis led to the same degree of prevention of alopecia. Adverse events (AE) were reported in 5 % (most frequently, sensation of cold), and 30 patients (13 %) discontinued cooling measures after cycle 1. Conclusions: In this first comparison published to date, both PAX and CC offer efficacious protection against hair loss, in particular when docetaxel is administered in a 3-weekly interval.
- Subjects
BALDNESS treatment; DRUG efficacy; DRUG tolerance; SCALP; DISEASES; DOCETAXEL; CONFIDENCE intervals; HEALTH outcome assessment
- Publication
Supportive Care in Cancer, 2013, Vol 21, Issue 9, p2565
- ISSN
0941-4355
- Publication type
Article
- DOI
10.1007/s00520-013-1804-9