Does Scalp Cooling Have the Same Efficacy in Black Patients Receiving Chemotherapy for Breast Cancer?
Mené sur 30 patientes afro-américaines atteintes d'un cancer de stade I à III, cet essai de phase II évalue l'intérêt d’un dispositif de refroidissement du cuir chevelu pour prévenir une alopécie induite par la chimiothérapie
Background : The Paxman scalp cooling (SC) device is FDA‐approved for prevention of chemotherapy‐induced alopecia (CIA). Studies report 50%–80% success rates and high patient satisfaction, yet there have been no studies of SC in Black patients. We conducted a phase II feasibility study of Paxman SC with a planned enrollment of 30 Black patients receiving chemotherapy for stage I–III breast cancer. Methods : Black patients who planned to receive ≥4 cycles of chemotherapy with non‐anthracycline (NAC) or anthracycline (AC) regimens were eligible. Alopecia was assessed by trained oncology providers using the modified Dean scale (MDS) prior to each chemotherapy session. Distress related to alopecia was measured by the Chemotherapy Alopecia Distress Scale (CADS). Conclusion : SC may not be efficacious in preventing alopecia in Black women. Differences in hair thickness, hair volume, and limitations of cooling cap design are possible contributing factors. Results : 15 patients enrolled in the intervention before the study was closed early due to lack of efficacy. Median MDS and CADS increased after SC suggesting increased hair loss (p < .001) and alopecia distress (p = .04). Only one participant was successful in preventing significant hair loss; the majority stopped SC before chemotherapy completion due to grade 3 alopecia (>50% hair loss).
The Oncologist 2021