Macduff C, Mackenzie T, Hutcheon A, Melville L, Archibald H
Centre for Nurse Practice Research and Development, The Robert Gordon University, Aberdeen, UK.
Eur J Cancer Care (Engl). 2003 Jun;12(2):154-61. doi: 10.1046/j.1365-2354.2003.00382.x.
The aim of this study was to establish the effectiveness of scalp cooling in preventing alopecia for patients with breast cancer who received the trial combination chemotherapy of Epirubicin and Docetaxel. Doubt remains about the general effectiveness of scalp cooling in preventing hair loss for patients receiving chemotherapy. There is very little information available about its specific effectiveness with combinations of Taxanes and Anthracycline drugs. Of the 40 patients who received this drug combination, 10 were included in a pilot study whereas the remaining 30 constituted the main study sample. A randomized controlled study was undertaken whereby the intervention group received scalp cooling via gel cool caps and the control group received no specific preventative intervention. Nurses assessed participants' hair loss using a modified version of the WHO scale at seven time points and also recorded hair loss photographically. Two independent experts rated the photographs using the same scale. Patients self-reported in relation to overall hair loss, hair condition, levels of emotional upset, negativity about appearance, hair re-growth and wig use. Significantly greater hair loss was apparent in the control group during most of the treatment period. However, the level of protection afforded by the cool caps was relatively poor with this chemotherapy combination. The marginal benefits of scalp cooling in this context must be clearly explained to patients.
本研究的目的是确定头皮冷却对接受表柔比星和多西他赛联合化疗的乳腺癌患者预防脱发的有效性。对于接受化疗的患者，头皮冷却预防脱发的总体有效性仍存疑问。关于其在紫杉烷类和蒽环类药物联合使用时的具体有效性，可用信息极少。在接受这种药物联合治疗的40名患者中，10名被纳入一项试点研究，其余30名构成主要研究样本。进行了一项随机对照研究，干预组通过凝胶冷却帽进行头皮冷却，对照组未接受特定的预防干预。护士在七个时间点使用世界卫生组织量表的修订版评估参与者的脱发情况，并拍摄脱发照片记录。两名独立专家使用相同量表对照片进行评分。患者就总体脱发、头发状况、情绪困扰程度、对外表的负面看法、头发生长和假发使用情况进行自我报告。在大多数治疗期间，对照组的脱发明显更严重。然而，对于这种化疗联合方案，冷却帽提供的保护水平相对较差。在这种情况下，必须向患者清楚解释头皮冷却的边际益处。
