Chemotherapy induced alopecia (CIA) is a distressing side effect of chemotherapy.1 Scalp cooling prevents hair loss by causing vasoconstriction and reducing exposure of cytotoxic agents to hair follicles. It is hypothesized that slower metabolism and higher peak concentrations of chemotherapy result in less effective scalp cooling.
Our study aims to assess the effect of scalp cooling at the Kinghorn Cancer Centre. This will include its efficacy in preventing hair loss, impact on quality of life, and the relationship between the peak plasma concentration of chemotherapy drugs and response to scalp cooling.
We will collect prospective data on thirty women with early breast cancer receiving scalp cooling with a Paxman Scalp Cooling device from June 2016 until January 2017. To measure degree of hair loss, we have built into our MOSAIQ database the Dean’s scale for hair loss and the NCI CTCAE scale. A nurse will assess and take photographs of hair cover and record data in MOSAIQ. Quality of life will be measured by the Chemotherapy-induced Alopecia Distress Scale (CADS).2 Patients fill out this questionnaire at each cycle and 3 months post completion of chemotherapy. In collaboration with the Clinical Pharmacology Department, we will conduct a feasibility study involving blood collection from patients having scalp cooling to measure peak plasma concentration of chemotherapy drugs docetaxel and cyclophosphamide, and the relationship to the degree of hair loss with scalp cooling.
Data generated from this study is important for quality assurance to ensure our rates of scalp cooling are consistent with published data.3. We aim to link data collected prospectively in MOSAIQ with an international collaboration developing a new quality of life data tool that will be available in the next 12 months.3 Understanding the relationship between peak chemotherapy concentration and the effectiveness of scalp cooling may help individualise scalp cooling, such as determining post-infusion cooling times.