Safety and effectiveness of scalp cooling in cancer patients undergoing cytotoxic treatment

Author(s):
Hurk, C.J.G. van den
Published
2013
Publication type
Doctoral Thesis

Abstract

Various cytotoxics cause severe alopecia, it is estimated to affect more than 15.000 Dutch cancer patients per year. Hair loss has high impact on the majority of these patients, they describe it as stigmatizing and a constant reminder of cancer disease. Scalp cooling decreases hair loss and is well tolerated. It however induces a risk if it would protect micro-metastases in the scalp skin besides protection of hair matrix cells. In thousands of patients with solid tumors, an unfavourable development of the disease due to scalp cooling has never been reported. Furthermore, data from the Dutch Scalp Cooling Registry showed that overall 50% of the 1,411 scalp-cooled patients from 28 Dutch hospitals did not wear a head cover during their last chemotherapy session. And a randomized trial showed that the post-infusion cooling time (PICT) for 3-weekly docetaxel chemotherapy can be shortened from 90 to 45 minutes with the same effectiveness of scalp cooling. Scalp cooling is cost-effective, as is purchasing a wig or head cover. This justifies the choice between both options. Effectiveness of scalp cooling has to be and will be improved, preferably by examining optimal scalp skin temperatures and cooling times, with special attention for the patient__s tolerance. At the time of starting this PhD project, 4 Dutch hospitals applied scalp cooling, which nowadays has increased to over 75. Though, in many hospitals scalp cooling eligibility criteria are too restricted, inducing undertreatment of several patient groups. All patients facing severe alopecia should receive patient-tailored information about the possibility, effectiveness, possible side-effects and potential risk of scalp cooling in order to make an informed treatment decision

Scalp coolingChemotherapySupportive careAlopeciaHair lossChemotherapy-induced hair loss
Defense date
2013-09-19
Language
English
Supervisor(s)
Nortier, J.W.R.; Coebergh, J.W.W.; Poll-Franse, L.V. van der
Advisor(s)
Breed, W.P.M.
Qualification
Ph.D.
Degree granting institution
Leiden University Medical Center (LUMC), Leiden University, Leiden
hdl
1887/21761
ISBN(s)
9789461084897

Funding

Sponsorship
Leids Universitair Medisch Centrum, Leiden, The Netherlands Paxman Coolers Ltd, Huddersfield, UK Integraal Kankercentrum Zuid, Eindhoven, The Netherlands Incomed B.V., Laarbeek, The Netherlands Vierpool B.V., Maarssen, The Netherlands Intermédica Kliniek voor haarziekten, Geldermalsen, The Netherlands Sanofi-Aventis Nederland B.V., Gouda, The Netherlands Teva Nederland B.V., Haarlem, The Netherlands Merck Sharp & Dohme B.V., Haarlem, The Netherlands Stichting Olijf, Amsterdam, The Netherlands (www.olijf.nl)