Kearney Caitlin A, Gordon Allison, Markova Alina, Freites-Martinez Azael, Tattersall Ian W, Shapiro Jerry, Lacouture Mario E, Lo Sicco Kristen I
The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA.
Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Skin Appendage Disord. 2025 Aug 22. doi: 10.1159/000548112.
Chemotherapy-induced alopecia (CIA) significantly impacts patients' quality of life. While low-dose oral minoxidil (LDOM) shows promise in treating CIA after chemotherapy completion, its safety and efficacy when given during active chemotherapy remain unclear. This review examined existing literature on CIA pathogenesis, minoxidil's mechanism of action, and LDOM efficacy to explore its potential use during chemotherapy.
Recent retrospective studies demonstrated LDOMs good tolerability in cancer patients post-chemotherapy, with minimal adverse effects. Scalp cooling, the only Food and Drug Administration-cleared intervention to mitigate CIA, is thought to reduce chemotherapeutic delivery to the hair follicles, whereas minoxidil, a vasodilator, increases blood flow to the follicle. Despite these differing mechanisms, preclinical studies suggest potential benefits of LDOM during chemotherapy. One study demonstrated a protective effect of subcutaneous minoxidil against cytarabine-induced alopecia, while another showed faster regrowth with systemic minoxidil administered concurrently with paclitaxel. LDOM may, therefore, exert benefits through mechanisms beyond vasodilation, potentially by its impact on the hair cycle. Studies on topical minoxidil during chemotherapy show variable results, possibly due to poor adherence or variations in application practices - limitations LDOM could address.
Given the psychological impact of CIA and limited treatments, investigation of LDOM's safety and efficacy when initiated during chemotherapy is warranted.
化疗所致脱发（CIA）对患者的生活质量有显著影响。虽然低剂量口服米诺地尔（LDOM）在化疗结束后治疗CIA方面显示出前景，但其在化疗进行期间使用时的安全性和有效性仍不明确。本综述研究了关于CIA发病机制、米诺地尔作用机制以及LDOM疗效的现有文献，以探讨其在化疗期间的潜在用途。
近期的回顾性研究表明，LDOM在化疗后的癌症患者中耐受性良好，不良反应极少。头皮冷却作为唯一经美国食品药品监督管理局批准用于减轻CIA的干预措施，被认为可减少化疗药物输送至毛囊，而血管扩张剂米诺地尔则可增加流向毛囊的血流量。尽管机制不同，但临床前研究表明LDOM在化疗期间可能有益。一项研究证明皮下注射米诺地尔对阿糖胞苷所致脱发有保护作用，另一项研究则显示米诺地尔与紫杉醇同时全身给药时毛发生长更快。因此，LDOM可能通过血管扩张以外的机制发挥作用，可能是因其对毛发生长周期的影响。化疗期间局部使用米诺地尔的研究结果不一，可能是由于依从性差或应用方法存在差异——而LDOM可能解决这些局限性。
鉴于CIA的心理影响以及治疗方法有限，有必要研究在化疗期间开始使用LDOM的安全性和有效性。
