Comparable effectiveness of 45- and 20-min post-infusion scalp cooling time in preventing paclitaxel-induced alopecia — a randomized controlled trial

• Published in: Supportive care in cancer 2022-08, Vol.30 (8), p.6641-6648
• Main Authors: Lugtenberg, Rieneke T., van den Hurk, Corina J. G., Smorenburg, Carolien H., Mosch, Linda, Houtsma, Danny, Deursen, Margaret A. G. den Hollander-van, Kaptein, Ad A., Gelderblom, Hans, Kroep, Judith R.
• Format: Article
• Language: English
• Subjects: Alopecia; Antimitotic agents; Antineoplastic agents; Baldness; Cancer; Care and treatment; Chemotherapy; Comparative analysis; Cooling; Hair loss; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Prevention; Rehabilitation Medicine
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-022-07090-7

Purpose Scalp cooling can prevent chemotherapy-induced alopecia (CIA). Previously, the post-infusion cooling time (PICT) could be successfully reduced in docetaxel-treated patients from 90 to 45 and 20 min. Therefore, it seems plausible that the PICT can be shortened for paclitaxel-treated patients as well. Methods Patients treated with weekly paclitaxel were included in this multi-centre trial and randomly assigned to a PICT of 45 or 20 min. The results were compared to a standard PICT of 90 min, derived from prospective collected data from the Dutch Scalp Cooling Registry. The primary endpoint was the percentage of patients who decide to not wear a wig or head covering. Secondary endpoints were the degree of CIA assessed with the Dean scale for assessment of hair loss; alopecia graded according to NCI CTC toxicity version 4.03 (CTCAE4.03); tolerance of scalp cooling and perceived distress of CIA. Results Ninety-one patients were enrolled in this study; 74 patients were evaluable for hair loss. Hair preservation was successful in 27 patients (75%) with a PICT of 45 min and in 31 patients (82%) with a PICT of 20 min. There was no difference in success rate with the standard PICT of 90 min (85%, p  = 0.29). Similar success rates were seen when using the Dean scale and CTCAE assessment, with no differences between groups ( p  = 0.12 and p  = 0.38). Conclusions A 20 min PICT is as effective as 45 and 90 min to prevent weekly paclitaxel-induced alopecia and should be the new standard of care. Trial register ClinicalTrials.gov Identifier: NCT03266185.