Prevention of chemotherapy-induced alopecia using an effective scalp cooling system

Alopecia is a distressing side-effect of cancer treatment. Taxanes (TX). an thracyclines (ANR) and etoposide (ET) have been consistently associated wit h significant alopecia. We studied an effective scalp cooling system, the P enguin Cold Cap system(TM), for the prevention of chemotherapy-induced alop ecia in 70 patients receiving chemotherapy, including one of the following major alopecia-causing agents: Group A, TX-based regimes (without ANR); Gro up B. TX + ANR: Group C, ANR-based regimes (without TX): Group D, ET-based regimes. Protection from hair loss was achieved by maintaining scalp temper atures below 15 degrees C before, during and after chemotherapy by frequent changing of the caps. Assessment was carried out using a grading system Fr om 0 to 4. Grades 0-2 were considered as satisfactory hair protection, whil st Grades 3-4 were considered failures. 57 patients were evaluable for asse ssment. An overall 81% protection was achieved. In groups C and D 11 of 12 patients (92%) had no alopecia, whilst 30 of 34 patients (88%) treated with taxanes had adequate hair protection. In Group B, 4 of 11 patients (36%) h ad adequate hair protection. The system was well tolerated and is a very ef fective method for protection from hair loss caused by TX, ANR and ET. Our results are comparable with and, in most cases, better than those reported in other studies using various alopecia preventive methods. (C) 2000 Elsevi er Science Ltd. All rights reserved.