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Retrospective cohort study of scalp cooling in breast cancer patients

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Abstract

For patients with cancer, alopecia is a common side effect that negatively impacts personal identity, body image, self-esteem, quality of life, and medical decision-making. Scalp cooling is a technique used to prevent alopecia in patients undergoing chemotherapy in which patients wear a cooled cap during chemotherapy infusions, causing localized vasoconstriction of blood vessels on the scalp. Because of the recent emergence of scalp cooling, there is a need to explore further the reasons why patients pursue this treatment. A retrospective chart review of women with breast cancer treated at The Ohio State University was conducted to investigate how factors such as patient age, race, ethnicity, insurance status, stage of cancer, and chemotherapy regimen influenced patients’ decisions to incorporate scalp cooling into their treatment plan as compared to those who did not. Findings revealed that patient age, race, insurance status, and chemotherapy regimen were predictors of a patient’s likelihood to undergo scalp cooling. Patients diagnosed at younger age and those with private insurance were more likely to utilize scalp cooling. In comparison to White patients, non-White patients were less likely to choose scalp cooling. Furthermore, patients placed on the chemotherapy regimen of AC or AC-T were less likely to pursue scalp cooling than patients on PTCH or TC regimens. These findings provide background for the development of educational resources for both patients interested in this therapy and healthcare providers discussing this treatment option in dermatology and oncology settings.

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References

  1. Mustoe M, Lee C, Melisko M, Esserman L, Rugo H (2018) The DigniCap Scalp Cooling System and its use in the treatment of chemotherapy-induced alopecia. Fut Oncol 14(24):2461. https://doi.org/10.2217/fon-2018-0178

    Article  CAS  Google Scholar 

  2. Treub R (2010) Chemotherapy induced hair loss. Skin Ther Lett 15(7):5–7

    Google Scholar 

  3. Coates A, Abraham S, Kaye SB, Sowerbutts T, Frewin C, Fox R, Tattersall M (1983) On the receiving end–patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19(2):203–208. https://doi.org/10.1016/0277-5379(83)90418-2

    Article  CAS  PubMed  Google Scholar 

  4. McGarvey E, Baum L, Pinkerton R, Rogers L (2008) Psychological sequelae and alopecia among women with cancer. Cancer Pract 9(6):283–289. https://doi.org/10.1111/j.1523-5394.2001.96007.pp.x

    Article  Google Scholar 

  5. Mundstedt K, Manthey N, Sachsse S, Vahrson H (1997) Changes in self-concept and body image during alopecia induced chemotherapy. Support Care Cancer 5(2):139–143. https://doi.org/10.1056/NEJM197912273012605

    Article  Google Scholar 

  6. Hesketh PJ, Batchelor D, Golant M et al (2004) Chemotherapy-induced alopecia: psychosocial impact and therapeutic approaches. Support Care Cancer 12:543–549. https://doi.org/10.1007/s00520-003-0562-5

    Article  PubMed  Google Scholar 

  7. Hackbarth M, Haas N, Fotopoulou C, Lichtenegger W, Sehouli J (2008) Chemotherapy-induced dermatological toxicity: frequencies and impact on quality of life in women’s cancers. Results of a prospective study. Support Care Cancer 3:267–273

    Article  Google Scholar 

  8. Moscetti et al (2015) Adjuvant aromatase inhibitor therapy in early breast cancer: what factors lead patients to discontinue treatment? Tumori 101(5):469–473

    Article  CAS  PubMed  Google Scholar 

  9. Dean J, Salmon S, Griffith K (1979) Prevention of doxorubicin-induced hair loss with scalp hypothermia. N Engl J Med 301:1427–2142. https://doi.org/10.1056/NEJM197912273012605

    Article  CAS  PubMed  Google Scholar 

  10. Prischel C (2016) Is scalp cooling the right decision for your patients? Oncol Nursing Soc Voice Retrieved on 11/21/2020, https://voice.ons.org/news-and-views/is-scalp-cooling-the-right-decision-for-your-patients. Accessed 15 Sept 2021

  11. Van den Hurk J, Peerbooms M, van de Poll-Franse L, Nortier J, Coebergh J, Breed W (2012) Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients - results of the Dutch Scalp Cooling Registry. Acta Oncol 51(4):497–504. https://doi.org/10.3109/0284186X.2012.658966

    Article  CAS  PubMed  Google Scholar 

  12. Cigler T, Isseroff D, Fiederlein B, Schneider S, Chuang E, Vahdat L, Moore A (2015) Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients receiving adjuvant docetaxel and cyclophosphamide chemotherapy. Clin Breast Cancer 5:332–334. https://doi.org/10.1016/j.clbc.2015.01.003

    Article  CAS  Google Scholar 

  13. Rugo H, Klein P, Cigler T (2017) Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer. J Am Acad Med 317(6):606–614. https://doi.org/10.1001/jama.2016.21038

    Article  Google Scholar 

  14. Dilawari A, Gallagher C, Alintah P, Chitalia A, Tiwari S, Paxman R, Adams-Campbell L, Dash C (2021) Does scalp cooling have the same efficacy in black patients receiving chemotherapy for breast cancer? Oncol 26(4):292-e548. https://doi.org/10.1002/onco.13690

    Article  CAS  Google Scholar 

  15. A degree of control: a guide to scalp cooling. Paxman US Incorporated. https://www.stlukes-stl.com/services/womens-services/documents/paxman-scalp-cooling-system.pdf .Accessed 10 Oct 2021

  16. Janssen F, Van Leeuwen G, Van Steenhoven A (2005) Modeling of temperature and perfusion during scalp cooling. Phys Med Biol 50(17):4065–73

  17. Araoye E, Stearns V, Aguh C (2020) Considerations for the use of scalp cooling devices in Black patients. J Clin Oncol 38(30):3575–3576. https://doi.org/10.1200/JCO.20.02130

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ohsumi S, Kiyoto S, Takahashi M, Hara F, Takashima S, Aogi K, Matsuda M, Yamamura N, Doi M (2021) Scalp cooling for hair loss in prevention in Japanese breast cancer patients receiving (neo)adjuvant chemotherapy. Support Care Cancer 29(1):437–444. https://doi.org/10.1007/s00520-020-05506-w

    Article  PubMed  Google Scholar 

  19. Nabe D, Schmitz I, Nabe A, von Hehn U, Voigtmann R (2015) The influence of various parameters on the success of sensor-controlled scalp cooling in preventing chemotherapy-induced alopecia. Oncol Res Treat 38(10):489–495. https://doi.org/10.1159/000440636

    Article  Google Scholar 

  20. Holowatz L, Kenney W (2010) Peripheral mechanisms of thermoregulatory control of skin blood flow in aged humans. J Appl Physiol 109(5):1538–1544. https://doi.org/10.1152/japplphysiol.00338.2010

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hurria A, Lichtman S (2007) Pharmacokinetics of chemotherapy in the older patient. Cancer Control 14(1):32–43. https://doi.org/10.1177/107327480701400105

    Article  PubMed  Google Scholar 

  22. Hope’s Boutique (2022) https://hopes-boutique-osu.nbsstore.net/. Accessed 10 Oct 2021

  23. Jagsi R, Pottow J, Griffith K et al (2014) Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. J Clin Oncol 32:1269–1276. https://doi.org/10.1200/JCO.2013.53.0956

    Article  PubMed  PubMed Central  Google Scholar 

  24. Komen M, Smorenburg C, van den Hurk C, Nortier J (2013) Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia. Oncol 18(7):885–891. https://doi.org/10.1634/theoncologist.2012-0332

    Article  Google Scholar 

  25. Kang D et al (2020) Permanent chemotherapy-induced alopecia in patients with breast cancer: a three year prospective cohort study. Oncol 24(3):414–420. https://doi.org/10.1634/theoncologist.2018-0184

    Article  CAS  Google Scholar 

  26. Nangia J et al (2017) Scalp Cooling Alopecia Prevention trial (SCALP) for patients with early stage breast cancer. J Clin Oncol 35(15):10088. https://doi.org/10.1200/JCO.2017.35.15_suppl.10088

    Article  Google Scholar 

  27. van den Hurk CJ, Mols F, Vingerhoets AJ, Breed WP (2010) Impact of alopecia and scalp cooling on the well-being of breast cancer patients. Psychooncol 19:701–709. https://doi.org/10.1002/pon.1615

    Article  Google Scholar 

  28. Bajpai J, Kagwade S, Chandraesekharan A et al. (2020) Randomised controlled trial of scalp cooling preservation of chemotherapy induced alopecia. Breast 49:187–193. https://doi.org/10.1016/j.breast.2019.12.004

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Authors and Affiliations

  1. The Ohio State University College of Medicine, Columbus, OH, USA

    Lucy Rose

  2. The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Patrick M. Schnell, Lindsey Radcliff & Brittany Dulmage

  3. Breast Cancer Center, Smilow Cancer Hospital, Yale University, New Haven, CT, USA

    Maryam Lustberg

  4. Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, OH, 43230, Gahanna, USA

    Brittany Dulmage

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The initial draft of the manuscript was written by Lucy Rose, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Brittany Dulmage.

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Rose, L., Schnell, P.M., Radcliff, L. et al. Retrospective cohort study of scalp cooling in breast cancer patients. Support Care Cancer 31, 118 (2023). https://doi.org/10.1007/s00520-022-07562-w

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