A study recently published in The Breast found that both automated scalp cooling systems and chemical cooling caps can help prevent chemotherapy-induced hair loss in people with breast cancer, though the two approaches showed differences in effectiveness at various stages of treatment and in patient-reported outcomes.
The prospective, randomized trial involved 152 patients with breast cancer who were scheduled to receive chemotherapy regimens known to commonly cause hair loss. Researchers randomly assigned the participants to use either an automated scalp cooling device or a chemical cooling cap during treatment.
Participants underwent a standard chemotherapy regimen consisting of four cycles of anthracycline followed by four cycles of a taxane. Researchers assessed hair loss using the World Health Organization toxicity grading scale, while quality of life and psychological wellbeing were measured using validated questionnaires.
Of the total participants, 117 completed the full observation period. By the end of treatment, hair preservation success rates were high in both groups but slightly higher in the automated system group. Nearly 75% of those using the scalp cooling system achieved hair preservation compared with 71% of those using the chemical cooling cap.
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Although the overall success rates were similar, the machine-based scalp cooling system demonstrated superior early protection during the anthracycline phase of chemotherapy, a stage known to cause particularly aggressive hair loss. This suggests the automated system may provide more consistent temperature control during the most hair-damaging part of treatment.
But the study found chemical cooling caps offered advantages, as well. Participants using these traditional cooling caps reported significantly lower anxiety scores and better overall quality-of-life measures compared with those using the automated cooling device.
“This may be due to the patients’ subjective perception that the convenience and comfort of the intervention is equally important to the intervention effect,” the researchers wrote. They noted that the scalp cooling system device was quite large and elicited confusion and strange looks from other patients. Chemical caps, on the other hand, are increasingly standard, making them more familiar and accepted.
Both cooling approaches were found to be safe and well tolerated, with no unexpected adverse effects linked to scalp cooling. The researchers call for more clinical trials to further evaluate the efficacy and cost-utility of scalp cooling to reduce chemotherapy-induced hair loss.
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