Prochilo Tiziana, Huscher Alessandra, Andreis Federica, Mirandola Mara, Zaina Elisabetta, Pomentale Barbara, Pedrali Chiara, Zanotti Laura, Mutti Stefano, Zaniboni Alberto
Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.
Radiotherapy, Fondazione Poliambulanza, Brescia, Italy.
Rev Recent Clin Trials. 2019;14(1):66-71. doi: 10.2174/1574887113666181120111104.
The most effective agents in the treatment of breast cancer have a common side effect, the hair loss. Some studies reported a reduction of hair loss with the use of the scalp cooling device. Indeed, it decreases the drug accumulation in the hair follicles. We report our preliminary experience with a scalp cooling device in reducing chemotherapy-induced alopecia and related distress in breast cancer patients undergoing adjuvant chemotherapy.
Hair loss grading and treatment tolerability were evaluated during chemotherapy every 21 days and 3 weeks after the last cycle of chemotherapy via Dean's scale by patients and operators and a comfort analogic scale by patients. We administered the Hospital Anxiety and Depression Scale questionnaire at the baseline and at the end of treatment to assess the distress related to chemotherapy- induced alopecia.
Among the 46 patients identified, 27 accepted the device. The eligible chemotherapy regimens included docetaxel+cyclophosphamide (TC), doxorubicin+cyclophosphamide (AC) and paclitaxel (P) weekly+trastuzumab (T). 24 pts (89%) completed the treatment; 3 pts (11%) treated with AC prematurely interrupted use of the scalp-cooling device due to inefficacy. After the last cycle of chemotherapy, the number of patient who perceived a HL < grade 2 was 16 (59%). The hair retention reported by operators has been higher (78%). 81.5% of patients well tolerated the treatment.
In our study, the scalp-cooling device reduced chemotherapy-induced alopecia in taxane- based chemotherapy. Furthermore, it suggests a discordance in hair loss perception between patients and operators.
治疗乳腺癌最有效的药物都有一个共同的副作用,即脱发。一些研究报告称,使用头皮冷却装置可减少脱发。事实上,它能减少药物在毛囊中的蓄积。我们报告了我们在乳腺癌辅助化疗患者中使用头皮冷却装置减少化疗引起的脱发及相关困扰的初步经验。
在化疗期间每21天以及化疗最后一个周期后3周,通过患者和操作人员使用迪恩量表以及患者使用舒适度模拟量表来评估脱发分级和治疗耐受性。我们在基线和治疗结束时发放医院焦虑抑郁量表问卷,以评估与化疗引起的脱发相关的困扰。
在确定的46例患者中,27例接受了该装置。符合条件的化疗方案包括多西他赛+环磷酰胺(TC)、阿霉素+环磷酰胺(AC)以及每周紫杉醇(P)+曲妥珠单抗(T)。24例患者(89%)完成了治疗;3例接受AC治疗的患者(11%)因无效而提前中断了头皮冷却装置的使用。化疗最后一个周期后,感觉脱发<2级的患者有16例(59%)。操作人员报告的头发保留率更高(78%)。81.5%的患者对治疗耐受性良好。
在我们的研究中,头皮冷却装置减少了紫杉类化疗中化疗引起的脱发。此外,这表明患者和操作人员在脱发感知方面存在不一致。