Cuidados paliativos y medicina

Abstracto

Efficacy of a Silicon Based Continuous Scalp Cooling System with Thermostat on Chemotherapy Induced Alopecia

Tony Ibrahim, Joseph Kattan, Tarek Assi, Georges Chahine, Fadi E Karake, Fadi Nasr and Marwan Ghosn

Introduction: Alopecia although reversible, is one of the most distressing side effects of chemotherapy. Preventive measures mainly focus on scalp cooling with variable and unpredictable efficacy reported in the literature. The objective of this work is to test the tolerance and effectiveness of a new silicon based cooling technique in preventing chemotherapy induced alopecia (CIA) after each of six cycles of chemotherapy. Method: This is a one center prospective descriptive study. Included patients were females receiving Taxanes and/or Adriamycin based regimens at the oncology department of Hotel-Dieu de France University Hospital. Cooling was done using the Orbis-Paxman scalp cooling system. Hair loss severity was evaluated using the World Health Organization (WHO) grading system. Failure or success of cooling was defined on the basis of wig or head cover use. Independent factors like age, type of hair, type and dose of chemotherapy, total and post infusion cooling time hemoglobin and creatinine at each course. Results: 81 patients were included. Success ranged between 84.8% and 96% for the repeated cycles. No association was found with the independent factors, except for the dose of chemotherapy in the first course with higher doses of Adriamycin (99 mg v/s 77 mg, p value 0.037) as well as taxanes (140 mg v/s 122 mg, p value 0.035) in patients experiencing failure. Conclusion: Scalp cooling has proved to be a successful and well tolerated prevention method for CIA in breast cancer patients treated by Taxanes and Adriamycin.