Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom.
Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom.
Oncologist. 2018 Jan;23(1):84-96. doi: 10.1634/theoncologist.2017-0263. Epub 2017 Sep 26.
Chemotherapy-induced alopecia (CIA) is the most visibly distressing side effect of commonly administered chemotherapeutic agents. Because psychological health has huge relevance to lifestyle, diet, and self-esteem, it is important for clinicians to fully appreciate the psychological burden that CIA can place on patients. Here, for the first time to our knowledge, we provide a comprehensive review encompassing the molecular characteristics of the human hair follicle (HF), how different anticancer agents damage the HF to cause CIA, and subsequent HF pathophysiology, and we assess known and emerging prevention modalities that have aimed to reduce or prevent CIA. We argue that, at present, scalp cooling is the only safe and U.S. Food and Drug Administration-cleared modality available, and we highlight the extensive available clinical and experimental (biological) evidence for its efficacy. The likelihood of a patient that uses scalp cooling during chemotherapy maintaining enough hair to not require a wig is approximately 50%. This is despite different types of chemotherapy regimens, patient-specific differences, and possible lack of staff experience in effectively delivering scalp cooling. The increased use of scalp cooling and an understanding of how to deliver it most effectively to patients has enormous potential to ease the psychological burden of CIA, until other, more efficacious, equally safe treatments become available.
Chemotherapy-induced alopecia (CIA) represents perhaps the most distressing side effect of chemotherapeutic agents and is of huge concern to the majority of patients. Scalp cooling is currently the only safe option to combat CIA. Clinical and biological evidence suggests improvements can be made, including efficacy in delivering adequately low temperature to the scalp and patient-specific cap design. The increased use of scalp cooling, an understanding of how to deliver it most effectively, and biological evidence-based approaches to improve its efficacy have enormous potential to ease the psychological burden of CIA, as this could lead to improvements in treatment and patient quality-of-life.
脱发是癌症患者最常面临的心理困扰之一，目前头皮冷却技术是唯一安全且经过美国食品和药物管理局（FDA）批准的脱发预防手段。本研究旨在评估该技术的临床效果和生物学基础，以明确其疗效和局限性，并探讨如何进一步优化头皮冷却技术以改善其疗效。
我们对现有文献进行了全面回顾，包括人类毛囊的分子特征、不同抗癌药物导致脱发的机制、随后的毛囊病理生理学以及现有的脱发预防手段。
脱发是癌症治疗最常见的副作用之一，严重影响患者的生活质量和心理健康。头皮冷却技术是目前唯一安全且经过 FDA 批准的脱发预防手段，但其疗效仍存在争议。临床和生物学证据表明，头皮冷却技术的疗效可以进一步提高，包括如何更有效地将低温传递到头皮以及针对患者个体差异的个性化设计等方面。
头皮冷却技术具有很大的应用潜力，可以减轻癌症患者的脱发心理负担，但仍需要进一步的研究和优化，以提高其疗效和患者的接受度。
