Medline ® Abstracts for References 86-88
of 'Chemotherapy-induced alopecia'
Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis.
Rugo HS, Melin SA, Voigt J
Breast Cancer Res Treat. 2017;163(2):199. Epub 2017 Mar 8.
PURPOSE: The risk of scalp metastases in patients using scalp cooling for preservation of hair during chemotherapy has been a concern but is poorly described.
METHODS: A systematic review and meta-analysis of longitudinal studies was undertaken to evaluate the effect of scalp cooling versus no scalp cooling on the risk of scalp metastasis in patients treated for breast cancer with chemotherapy. Electronic databases, journal specific, and hand searches of articles identified were searched. Patients were matched based on disease, treatment, lack of metastatic disease, and sex.
RESULTS: A total of 24 full-text articles were identified for review. Of these articles, ten quantified the incidence of scalp metastasis with scalp cooling over time. For scalp cooling, 1959 patients were evaluated over an estimated mean time frame of 43.1 months. For no scalp cooling, 1238 patients were evaluated over an estimated mean time frame of 87.4 months. The incidence rate of scalp metastasis in the scalp coolinggroup versus the no scalp cooling group was 0.61% (95% CI 0.32-1.1%) versus 0.41% (95% CI 0.13-0.94%); P = 0.43.
CONCLUSION: The incidence of scalp metastases was low regardless of scalp cooling. This analysis suggests that scalp cooling does not increase the incidence of scalp metastases.
University of California San Francisco Helen Diller Family Comprehensive Cancer Center, UCSF Medical Center at Mount Zion, 1600 Divisadero St, San Francisco, CA, 94115, USA.
Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer.
van den Hurk CJ, van de Poll-Franse LV, Breed WP, Coebergh JW, Nortier JW
With modern scalp cooling equipment cytotoxic damage of hair root cells can be prevented in half of the patients with cancer at high risk of alopecia. However, traditionally doubt has existed whether scalp cooling might facilitate hiding and disseminating scalp skin metastases and thus decrease survival. We discuss this risk using frequency data on metastases in breast cancer from observational and autopsy studies and the Munich cancer registry. They showed the incidence of scalp skin metastases to be very low and not differ between scalp-cooled (0.04-1%) and non scalp-cooled (0.03-3%) patients with breast cancer and in need of chemotherapy. We found it rather unlikely that the incidence of scalp skin metastases might increase at all after scalp cooling, whereas a very small proportion of patients receiving chemotherapy are at risk to develop metastases at this site. Scalp cooling can thus safely be offered to patients treated with alopecia-inducing chemotherapy.
Research Department, Eindhoven Cancer Registry/Comprehensive Cancer Centre South, PO Box 231, 5600 Eindhoven, The Netherlands. Electronic address: C.firstname.lastname@example.org.
Incidence of scalp metastases in breast cancer: a retrospective cohort study in women who were offered scalp cooling.
Lemieux J, Amireault C, Provencher L, Maunsell E
Breast Cancer Res Treat. 2009;118(3):547.
Scalp cooling is an intervention used to decrease the degree of chemotherapy-induced alopecia. The objective is to determine the incidence of scalp metastases among women with early breast cancer who received neoadjuvant or adjuvant chemotherapy. We conducted a retrospective cohort study of women with breast carcinoma diagnosed between June 1, 1998 and June 30, 2002. The median follow-up was 5.8 years (+/-1.7) for the scalp cooling group (n = 553) and 5.4 years (+/-1.7) for the non-scalp cooling group (n = 87). The incidence of scalp metastases was 1.1% (6 cases out of 553 patients) among women who used scalp cooling in the neoadjuvant or adjuvant setting and 1.2% also (1 case out of 87 patients) among women who did not use scalp cooling in the neoadjuvant or adjuvant setting. The incidence of scalp metastases was low and no case presented as an isolated site of relapse.
Service d'hématologie et oncologie, Centre des maladies du sein Deschênes-Fabia and Unitéde recherche en santédes populations of the Centre hospitalier affiliéuniversitaire de Québec, UniversitéLaval, 1050 Chemin Ste-Foy, Room JS1-01, Québec, QC, G1S 4L8, Canada. email@example.com