Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Preliminary results from an ongoing prospective cohort study of scalp hypothermia in the prevention of chemotherapy induced alopecia in rural New South Wales (#237)

Dean B Letchford 1 , Kirsty Baxter 1 , Stephen D Begbie 1 , Wasek Faisal 1
  1. Mid North Coast Cancer Institute, Port Macquarie, NEW SOUTH WALES, Australia

Clinical trials suggest that scalp hypothermia significantly reduces the risk of chemotherapy induced alopecia (CIA) from 75.9% in control groups to 28.9% in those who have scalp cooling (RR=0.38, 95% CI = 0.32-0.45). The results of these trials are difficult to interpret however, due to variable cooling devices, cooling times, chemotherapy regimens, and definitions of alopecia as well as small study designs. This ongoing prospective cohort study allocated 20 consenting patients, who received 11 varying chemotherapy regimens, to scalp cooling using the Paxman Orbis II device during their treatment. Each patient underwent scalp cooling for 30 minutes before administration of chemotherapy, during their infusion, and for 90 minutes after their infusion completed. The degree of hair loss was assessed using the WHO and Deans alopecia scale, digital photography and a patient self-reporting questionnaire. This was done prior to the start of each cycle of chemotherapy, as well as 3 weeks and 3 months following each patient’s final treatment. Alopecia was defined as a WHO / Deans grade of 2 or more. Six patients withdrew due to grade 2/3 alopecia and an additional three patients, who completed treatment with scalp cooling, developed grade 2 alopecia. Of note six patients treated so far with FEC (as part of the FEC-D protocol) or weekly paclitaxel developed grade 2/3 alopecia, and four patients treated with carboplatin / paclitaxel or TCH completed treatment with either grade 1 or no alopecia. 5 patients withdrew from study due to discomfort, but otherwise no adverse effects were associated with scalp cooling. Our study so far suggests that scalp hypothermia using modern scalp cooling systems represents a safe and effective method of reducing rates of CIA. Further clinical trials are required to indicate which patients / chemotherapy regimens will obtain maximal efficacy from scalp hypothermia in preventing CIA.