Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Efficacy of scalp cooling and pharmacokinetics at the Kinghorn Cancer Centre, St Vincent's Hospital (#368)

Kate Manollaras 1 , Linzi Nolan 1 , Richard Day 1 , Ross Norris 1 , Rachel Dear 1
  1. St Vincent's Hospital, Paddington, NSW, Australia

Background

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.

 

Aim

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. 

 

Methods

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.

 

Conclusion

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.

  1. 1. Impact of alopecia and scalp cooling on the well-being of breast cancer patients. Hurk van den CJ, Mols F, Vingerhoets AJ, Breed WP. Psychooncology. 2010;19(7):701-9.
  2. 2. Development and validation of Chemotherapy-induced Alopecia Distress Scale (CADS) for breast cancer patients. Cho J, Choi EK, Kim IR, Im YH, Parl YH, Lee S, Lee JE, Yang JH, Nam SJ. Annals of Oncology. 2013; 25: 346-51.
  3. 3. Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients – Results of the Dutch Scalp Cooling Registry. Hurk van den CJ, Peerbooms M, Poll-Franse van de LV, Nortier JW, Coebergh JW, Breed WP. Acta Oncologica. 2012; 51 (4): 497-504.
  4. 4. Chemotherapy Hair-Loss Innovation and Leadership (CHILL). Accessed 12 August 2016. www.scalpcooling.org