Department of Pathology, University of California-San Francisco, San Francisco, CA, USA.
Department of Dermatology, University of California-Irvine, Irvine, CA, USA.
Int J Dermatol. 2018 Dec;57(12):1417-1424. doi: 10.1111/ijd.13906. Epub 2018 Jan 29.
Chemotherapy-induced alopecia (CIA) is one of the most troubling long-lasting side effects of cancer treatment. An estimated 65% of patients undergoing classic chemotherapy will experience hair loss, which is an extremely upsetting adverse event for many. CIA has been traditionally considered to be a diffuse, nonscarring alopecia; however, there are increasing reports of permanent hair loss post chemotherapy. Despite its large impact on patients, there are few proven treatments for CIA. Recent advancements in understanding the pathogenesis of hair loss are promising novel preventative and therapeutic strategies. Currently, scalp cooling during chemotherapy is the most effective preventive intervention with response rates ranging from 50 to 80%. To avoid patient morbidity, clinicians should be aware of the pathogenesis of CIA, characteristic patterns of hair loss associated with specific drug regimens, preventive measures that may be taken, and therapeutic options post chemotherapy. The following represents an updated systematic review of CIA, including characteristic clinical patterns, pathophysiology of the disease, therapeutic approaches, as well as a cost-effective analysis to assess the significance of this toxicity.
化疗引起的脱发（CIA）是癌症治疗中最令人困扰的长期副作用之一。据估计，接受经典化疗的患者中有 65%会出现脱发，这对许多人来说是一个极其令人不安的不良事件。CIA 传统上被认为是一种弥漫性、非瘢痕性脱发；然而，越来越多的报告表明化疗后会永久性脱发。尽管它对患者有很大的影响，但 CIA 的治疗方法很少得到证实。最近对脱发发病机制的理解取得了进展，为预防和治疗提供了有前途的新策略。目前，化疗期间头皮冷却是最有效的预防干预措施，其反应率在 50%至 80%之间。为了避免患者发病，临床医生应了解 CIA 的发病机制、与特定药物方案相关的脱发特征模式、可能采取的预防措施以及化疗后的治疗选择。以下是对 CIA 的更新系统综述，包括其特征性临床模式、疾病的病理生理学、治疗方法，以及成本效益分析，以评估这种毒性的意义。
