Ross Mikel, Fischer-Cartlidge Erica
Memorial Sloan Kettering Cancer Center.
Clin J Oncol Nurs. 2017 Apr 1;21(2):226-233. doi: 10.1188/17.CJON.226-233.
BACKGROUND: More than 75% of patients with cancer cite alopecia as the most feared side effect of treatment, with as many as 10% considering treatment refusal. Despite wide acceptance in other countries, scalp cooling to reduce chemotherapy-induced alopecia (CIA) has been uncommon in the United States because of longstanding concerns of scalp metastases and a lack of reliable efficacy data. .
OBJECTIVES: This article reviews 40 years of efficacy, safety, and tolerability literature on scalp cooling to prevent CIA. .
METHODS: A systematic review was performed in PubMed and CINAHL®. Forty articles were reviewed, with 12 articles demonstrating high levels of evidence and meeting inclusion criteria. Comparative trials, systematic reviews, and one large single-arm trial were included. .
Scalp cooling efficacy is dependent on many factors but demonstrates better hair preservation than no cooling. No increase in scalp metastases or statistically significant difference in overall survival was seen in retrospective safety data when cooling was used. Few patients discontinue cooling early because of adverse experiences.
超过75%的癌症患者将脱发视为最害怕的治疗副作用，多达10%的患者考虑拒绝治疗。尽管头皮冷却在其他国家已被广泛接受，但由于长期以来对头皮转移的担忧以及缺乏可靠的疗效数据，在美国，用于减少化疗引起的脱发（CIA）的头皮冷却并不常见。
本文回顾了40年来关于头皮冷却预防CIA的疗效、安全性和耐受性的文献。
在PubMed和CINAHL®上进行了系统评价。共审查了40篇文章，其中12篇文章具有高水平的证据并符合纳入标准。纳入了比较试验、系统评价和一项大型单臂试验。
头皮冷却的疗效取决于许多因素，但与不进行冷却相比，其在保留头发方面表现更佳。在回顾性安全数据中，使用冷却时未发现头皮转移增加或总生存率有统计学上的显著差异。很少有患者因不良经历而提前停止冷却。
