Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Eur Acad Dermatol Venereol. 2018 May;32(5):720-734. doi: 10.1111/jdv.14612. Epub 2017 Nov 24.
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.
化疗引起的脱发（CIA）是一种暂时的、但具有心理破坏性的脱发形式，影响 65%接受癌症化疗的患者。20 世纪 70 年代，头皮低温被引入作为预防 CIA 发展的一种措施。许多研究提供了头皮冷却预防 CIA 的有效性证据，尽管由于化疗方案、冷却技术、给药方式和患者因素的不同，结果有所不同。然而，许多现有的研究是非对照的或样本量较小，随机、随机研究的数据有限。迄今为止，尚未制定头皮冷却作为治疗方式的最佳使用指南，其疗效也未知。尽管如此，头皮冷却仍然是预防 CIA 最广泛使用的方法，并且 2015 年 12 月，美国食品和药物管理局（FDA）批准了 DigniCap 头皮冷却系统（Dignitana AB，瑞典）用于营销，Orbis 从 Paxman Coolers Ltd. 获得批准在 2017 年。这篇文献综述是最早提供关于评估头皮低温预防 CIA 的对照和随机临床试验（CCT 和 RCT）的最新综述和并列比较之一。我们对 CCT 和 RCT 的分析表明，头皮低温在降低 CIA 的发生率方面是有效的，在 CCT 中降低了 2.7 倍，在 RCT 中降低了 3.9 倍。这些结果表明，头皮低温是 CIA 的一种有效预防措施，为化疗后预期脱发的管理和未来的研究提供了指导。
