Manon M C Komen1, Corina J G van den Hurk2, Johan W R Nortier3, Tjeerd van der Ploeg4, P Nieboer5, Jacobus J M van der Hoeven6, Carolien H Smorenburg7. 1. Department of Internal Medicine and Medical Oncology, Medical Centre Alkmaar, PO Box 501, AM, 1800, Alkmaar, The Netherlands. m.m.c.komen@nwz.nl. 2. Comprehensive Cancer Organisation the Netherlands, PO Box 19079, DB, 3501, Utrecht, The Netherlands. 3. Department of Medical Oncology, Leiden University Medical Centre, PO Box 9600, RC, 2300, Leiden, The Netherlands. 4. Business, Finance and Law department, Inholland Alkmaar, PO Box 501, AM, 1800, Alkmaar, The Netherlands. 5. Department of Medical Oncology, Wilhelmina Ziekenhuis Assen, Europaweg-Zuid 1, RK, 9401, Assen, The Netherlands. 6. Department of Medical Oncology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, GA, 6525, Nijmegen, The Netherlands. 7. Department of Medical Oncology, Antoni van Leeuwenhoek, Plesmanlaan 121, CX, 1066, Amsterdam, The Netherlands.
Abstract
PURPOSE: Scalp cooling as a method to reduce the incidence of chemotherapy-induced alopecia (CIA) is increasingly used in daily practice worldwide. However, in patients treated with 5-fluorouracil, epirubicin and cyclophosphamide (FEC), scalp cooling fails in 48-67% of patients. This study investigated the efficacy of extended duration of post-infusion scalp cooling in breast cancer patients treated with this regimen. METHODS: In this prospective multi-centre randomised study, 102 patients with early breast cancer treated withadjuvant FEC chemotherapy were randomly assigned in a 1:1 ratio to a post-infusion cooling time of 90 or 150 min. The primary endpoint was the need to wear a wig or other head covering to mask visible hair loss. RESULTS: Sixteen out of 48 patients (33%) treated with 90 min of post-infusion cooling did not need any head covering, compared with 21 out of 46 patients (45%) treated with 150 min of post-infusion cooling (p = 0.2). WHO grades 2-3 (moderate-complete) alopecia were reported more often in patients treated with 90-min post-infusion cooling time (n = 25/51 (49%) versus n = 17/51 (33%); p = 0,02). Scalp cooling was well-tolerated (mean Visual Analogue Score 7.4) and only three patients (3%) stopped due to intolerance during treatment. CONCLUSIONS: Extending the duration of 90-min post-infusion scalp cooling to 150 min in patients treated with adjuvant FEC chemotherapy was well-tolerated but did not significantly diminish the need for head covering. However, grades 2-3 alopecia was seen less often with prolonged post-infusion scalp cooling.
RCT Entities:
PURPOSE: Scalp cooling as a method to reduce the incidence of chemotherapy-induced alopecia (CIA) is increasingly used in daily practice worldwide. However, in patients treated with 5-fluorouracil, epirubicin and cyclophosphamide (FEC), scalp cooling fails in 48-67% of patients. This study investigated the efficacy of extended duration of post-infusion scalp cooling in breast cancerpatients treated with this regimen. METHODS: In this prospective multi-centre randomised study, 102 patients with early breast cancer treated with adjuvant FEC chemotherapy were randomly assigned in a 1:1 ratio to a post-infusion cooling time of 90 or 150 min. The primary endpoint was the need to wear a wig or other head covering to mask visible hair loss. RESULTS: Sixteen out of 48 patients (33%) treated with 90 min of post-infusion cooling did not need any head covering, compared with 21 out of 46 patients (45%) treated with 150 min of post-infusion cooling (p = 0.2). WHO grades 2-3 (moderate-complete) alopecia were reported more often in patients treated with 90-min post-infusion cooling time (n = 25/51 (49%) versus n = 17/51 (33%); p = 0,02). Scalp cooling was well-tolerated (mean Visual Analogue Score 7.4) and only three patients (3%) stopped due to intolerance during treatment. CONCLUSIONS: Extending the duration of 90-min post-infusion scalp cooling to 150 min in patients treated with adjuvant FEC chemotherapy was well-tolerated but did not significantly diminish the need for head covering. However, grades 2-3 alopecia was seen less often with prolonged post-infusion scalp cooling.
Entities:
Keywords:
Alopecia; Breast cancer; Chemotherapy; FEC; Hair loss; Scalp cooling
Authors: M M C Komen; C H Smorenburg; J W R Nortier; T van der Ploeg; C J G van den Hurk; J J M van der Hoeven Journal: Breast Date: 2016-09-28 Impact factor: 4.380
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