Scalp Cooling Has No Place in the Prevention of Alopecia in Adjuvant Chemotherapy for Breast Cancer

    January 1994 in “ European Journal of Cancer ”
    Robert A.E.M. Tollenaar, Gerrit‐Jan Liefers, O.J. Repelaer van Driel, Cornelis J.H. van de Velde
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    TLDR Scalp cooling is largely ineffective in preventing hair loss from breast cancer chemotherapy.
    The 1994 study assessed the effectiveness of scalp hypothermia in preventing chemotherapy-induced alopecia in 35 breast cancer patients undergoing adjuvant chemotherapy with a regimen including doxorubicin, cyclophosphamide, and 5-fluorouracil. The results indicated that scalp cooling was largely ineffective, with only 11% of patients experiencing acceptable hair preservation. The majority of patients either required a wig due to moderate alopecia (34%) or experienced complete alopecia (54%). The study concluded that scalp hypothermia might be effective only when an anthracycline is the sole alopecia-inducing agent and suggested that it has no role in preventing alopecia for the common combination chemotherapy regimens used in breast cancer. Additionally, the document highlighted concerns about the potential for scalp hypothermia to allow malignant cells to evade chemotherapy, and despite some minor successes in low-dosage regimens, the overall evidence does not support its use in most current adjuvant chemotherapy treatments.
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