Scalp cooling and chemotherapy: evaluation of quality of life and trichoscopy
DOI:
https://doi.org/10.33448/rsd-v12i6.41705Keywords:
Alopecia; Breast neoplasms; Drug therapy.Abstract
Objectives: This study aimed to evaluate the quality of life (QoL) of patients undergoing scalp cooling during chemotherapy and to describe hair density data assessed by trichoscopy. Background: Hair loss during chemotherapy is a common and distressing side effect, and prevention can be done through scalp hypothermia. Methods: A prospective cohort study was conducted at a single oncology center in Brazil. Patients undergoing scalp cooling during chemotherapy were included. QoL and body image satisfaction (BIS) questionnaires were administered at the beginning and end of treatment. Data on alopecia were collected. Trichoscopy with a Fotofinder® device was performed at the beginning, before the second cycle, and at the end of treatment. STROBE guidelines were followed for the development of this study. Results: Twenty-seven patients were included. There was no difference in mean QoL or BIS scores in the comparison of patients with hair loss < 50% with those with hair loss ≥ 50%. Better outcomes in the QoL and BIS scales were found in patients treated with anthracyclines. Hair density described by trichoscopy showed a maximum reduction of up to 16.3%, and loss was more common in the frontal area. Conclusions: Thus, there is no clear evidence of better QoL in patients with a lower grade of alopecia after scalp cooling during chemotherapy. Validated scales can be useful for assessing QoL in this population.
References
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., & de Haes, J. C. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 85(5), 365–376. https://doi.org/10.1093/jnci/85.5.365
Amarillo, D., De Boni, D., Cuello, M. (2022). Alopecia, quimioterapia y gorras de frío o «scalp cooling system». Actas Dermosifiliogr, 113(3), 278-283. https://doi.org/10.1016/j.ad.2021.09.003
Carbognin, L., Accetta, C., Di Giorgio, D., Fuso, P., Muratore, M., Tiberi, G., Pavese, F., D’Angelo, T., Fabi, A., Giannarelli, D., Di Leone, A., Magno, S., Garganese, G., Sanchez, A. M., Terribile, D. A., Franceschini, G., Masetti, R., Scambia, G., & Paris, I. (2022). Prospective study investigating the efficacy and safety of a scalp cooling device for the prevention of alopecia in women undergoing (neo) adjuvant chemotherapy for breast cancer. Curr Oncol, 29(10), 7218-7228. https://doi.org/10.3390/curroncol29100569
Cho, J., Choi, E. K., Kim, I. R., Im, Y. H., Park, Y. H., Lee, S., Lee, J. E., Yang, J. H., & Nam, S. J. (2014). Development and validation of chemotherapy-induced alopecia distress scale (CADS) for breast cancer patients. Ann Oncol, 25(2), 346–351. https://doi.org/10.1093/annonc/mdt476
Delgado-Sanz, M. C., García-Mendizábal, M. J., Pollán, M., Forjaz, M. J., López-Abente, G., Aragonés, N., & Pérez-Gómez, B. (2011). Heath-related quality of life in Spanish breast cancer patients: a systematic review. Health Qual Life Outcomes, 9: 3. https://doi.org/10.1186/1477-7525-9-3
Department of Health and Human Services (US), National Institutes of Health, National Cancer Institute. (2017). Common Terminology Criteria for Adverse Events (CTCAE). https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf
Dunnill, C. J., Al‐Tameemi, W., Collett, A., Haslam, I. S., & Georgopoulos, N. T. (2018). A clinical and biological guide for understanding chemotherapy‐induced alopecia and its prevention. Oncologist, 23(1), 84–96. https://doi.org/10.1634/theoncologist.2017-0263
Ferreira, M.C. & Leite, N. G. M. (2002). Adaptation and validation of an instrument for evaluation of body image satisfaction. Avaliação Psicol, 1(2), 141-149.
Haque, E., Alabdaljabar, M. S., Ruddy, K. J., Haddad, T. C., Thompson, C. A., Lehman, J. S., & Hashmi, S. K. (2020). Management of chemotherapy-induced alopecia (CIA): A comprehensive review and future directions. Crit Rev Oncol Hematol, 156, 103093. https://doi.org/10.1016/j.critrevonc.2020.103093
Jain, N., Doshi, B., & Khopkar, U. (2013). Trichoscopy in alopecias: diagnosis simplified. Int J Trichology, 5(4), 170–178. https://doi.org/10.4103/0974-7753.130385
Kanti, V., Nuwayhid, R., Lindner, J., Hillmann, K., Stroux, A., Bangemann, N., Kleine-Tebbe, A., Blume-Peytavi, U., & Garcia Bartels, N. (2014). Analysis of quantitative changes in hair growth during treatment with chemotherapy or tamoxifen in patients with breast cancer: A cohort study. Br J Dermatol, 170(3), 643–650. https://doi.org/10.1111/bjd.12716
Kate, S., Patil, R., Pathan, D., Vyavhare, R., Joseph, S., Baby, V., Ramesh Y. V., & Nagarkar, R. (2021). Safety and efficacy of scalp cooling system in preventing chemotherapy induced alopecia - A single center prospective study. Cancer Treat Res Commun, 26, 100280. https://doi.org/10.1016/j.ctarc.2020.100280
Komen, M. M. C., Smorenburg, C. H., Hurk, C. J. G., & Nortier, J. W. R. (2013). Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy‐induced alopecia. Oncologist, 18(7), 885–891. https://doi.org/10.1634/theoncologist.2012-0332
Marks, D. H., Okhovat, J. P., Hagigeorges, D., Manatis-Lornell, A. J., Isakoff, S. J., Lacouture, M. E., & Senna, M. M. (2019). The effect of scalp cooling on CIA-related quality of life in breast cancer patients: a systematic review. Breast Cancer Res Treat, 175(2), 267–276. https://doi.org/10.1007/s10549-019-05169-0
Nangia, J., Wang, T., Osborne, C., Niravath, P., Otte, K., Papish, S., Holmes, F., Abraham, J., Lacouture, M., Courtright, J., Paxman, R., Rude, M., Hilsenbeck, S., Osborne, K., & Rimawi, M. (2017). Effect of a scalp cooling device on alopecia inwomen undergoing chemotherapy for breast cancer: The SCALP randomized clinical trial. JAMA, 317(6), 596–605. https://doi.org/10.1001/jama.2016.20939
Ntellas, P., Spathas, N., Agelaki, S., & Zintzaras, E. (2019). Taxane & cyclophosphamide vs anthracycline & taxane-based chemotherapy as adjuvant treatment for breast cancer: a pooled analysis of randomized controlled trials by the Hellenic Academy of Oncology. Oncotarget, 10(11): 1209–1216. https://doi.org/10.18632/oncotarget.26632
Park, J. H., Jung, Y. S., Kim, J. Y., Jo, Y., & Bae, S. H. (2020). Trajectories of health-related quality of life in breast cancer patients. Support Care Cancer, 28(7), 3381–3389. https://doi.org/10.1007/s00520-019-05184-3
Pereira A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. Universidade Federal de Santa Maria (UFSM).
Rugo, H. S. & Voigt, J. (2018). Scalp hypothermia for preventing alopecia during chemotherapy. A systematic review and meta-analysis of randomized controlled trials. Clin Breast Cancer, 18(1), 19–28. https://doi.org/10.1016/j.clbc.2017.07.012
Shin, H., Jo, S. J., Kim, D. H., Kwon, O., & Myung, S. K. (2015). Efficacy of interventions for prevention of chemotherapy-induced alopecia: a systematic review and meta-analysis. Int J Cancer, 136(5), E442-54. https://doi.org/10.1002/ijc.29115
Syrowatka, A., Motulsky, A., Kurteva, S., Hanley, J. A., Dixon, W. G., Meguerditchian, A. N., & Tamblyn, R. (2017). Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat, 165(2), 229–245. https://doi.org/10.1007/s10549-017-4290-9
Vasconcelos, I., Wiesske, A., & Schoenegg, W. (2018). Scalp cooling successfully prevents alopecia in breast cancer patients undergoing anthracycline/taxane-based chemotherapy. Breast, 40: 1–3. https://doi.org/10.1016/j.breast.2018.04.012
Villarreal-Garza, C., Mesa-Chavez, F., Garza-Ledezma, M., Peña-Curiel, O., Martinez-Cannon, B. A., Canavati-Marcos, M., & Cardona-Huerta, S. (2021). Impact of chemotherapy regimen and sequence on the effectiveness of scalp cooling for alopecia prevention. Breast Cancer Res Treat, 185(2), 453–458. https://doi.org/10.1007/s10549-020-05968-w
Wang, S., Yang, T., Shen, A., Qiang, W., Zhao, Z., & Zhang, F. (2021). The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer, 29(11), 6943-6956. https://doi.org/10.1007/s00520-021-06188-8
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