Saad Marniza, Chong Flora Li Tze, Bustam Anita Zarina, Ho Gwo Fuang, Malik Rozita Abdul, Ishak Wan Zamaniah Wan, Ee Phua Vincent Chee, Yusof Mastura Md, Yap Ning Yi, Alip Adlinda
Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Clinical Oncology Unit, Faculty of Medicine, University of Malaya; Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Malaysia.
Indian J Cancer. 2018 Apr-Jun;55(2):157-161. doi: 10.4103/ijc.IJC_581_17.
Scalp cooling has been shown in several studies to be an effective method in preventing chemotherapy-induced alopecia (CIA). Data on the use of scalp cooling in Asian countries are limited, and evidence for its use and efficacy among our patients are not available.
The aim of this study was to assess the effectiveness and tolerability of scalp cooling among breast cancer patients in our study population.
Consecutive breast cancer patients receiving FEC, FEC, FEC-D, docetaxel or docetaxel, and cyclophosphamide (TC) at our treatment center were recruited and allocated to the treatment (scalp cooling, DigniCapTM system) or control group in this prospective nonrandomized controlled study. The assessment of alopecia was carried out using the World Health Organization grading system and clinical photographs.
Seventy patients were recruited, but only 25 completed the study and were evaluable for analysis. Five of 12 patients (42%) in the scalp cooling group managed to preserve hair. Two of three patients who received FEC and TC regimens had minimal hair loss. All patients treated with FEC had severe hair loss. Half of all patients who received scalp cooling throughout chemotherapy rated the treatment as reasonably well tolerated. The most common reason for discontinuing scalp cooling was intolerance to its side effects.
Scalp cooling is potentially effective in reducing CIA caused by docetaxel, TC, and FEC chemotherapy regimen. However, it was not well tolerated by our study population. The dropout rate was high, and this needs to be taken into consideration when pursuing further trials in a similar setting.
多项研究表明，头皮冷却术是预防化疗所致脱发（CIA）的有效方法。亚洲国家关于头皮冷却术使用的数据有限，且我们的患者群体中其使用及疗效的证据尚不充分。
本研究旨在评估头皮冷却术在我们研究人群中的乳腺癌患者中的有效性和耐受性。
在这项前瞻性非随机对照研究中，招募了在我们治疗中心接受氟尿嘧啶、表柔比星、环磷酰胺（FEC）、FEC-D、多西他赛或多西他赛与环磷酰胺（TC）治疗的连续乳腺癌患者，并将其分配至治疗组（头皮冷却，DigniCapTM系统）或对照组。使用世界卫生组织分级系统和临床照片对脱发情况进行评估。
共招募了70名患者，但只有25名完成了研究并可进行分析评估。头皮冷却组的12名患者中有5名（42%）成功保住了头发。接受FEC和TC方案治疗的3名患者中有2名脱发极少。所有接受FEC治疗的患者均出现严重脱发。在整个化疗过程中接受头皮冷却治疗的所有患者中，有一半认为该治疗的耐受性尚可。停止头皮冷却治疗的最常见原因是对其副作用不耐受。
头皮冷却术在减少多西他赛、TC和FEC化疗方案所致CIA方面可能有效。然而，我们的研究人群对其耐受性不佳。脱落率较高，在类似情况下进行进一步试验时需要考虑这一点。
