13 December 2016

Keep your head in the cold

The effectiveness of head cooling during chemotherapy was evaluated

Anna Stavina, XX2 century

Using a device to cool the head during chemotherapy can reduce the incidence of severe hair loss by 50%, according to a report presented at a Symposium on breast cancer in San Antonio (San Antonio Breast Cancer Symposium).

In half of the patients who used the electronic cap, hair fell out in moderate amounts, or did not fall out at all. An additional analysis of the results of the study showed that in the subgroup receiving therapy based on taxanes, drugs characterized by relatively mild side effects on the hair, the benefits of using the device were more pronounced. However, a fifth of patients who received more toxic anthracycline treatment managed to achieve the same effect – moderate hair loss or lack thereof.

"Side effects associated with the use of the device were recorded relatively rarely, the most common of them was headache," said the head of the work, Dr. Julie Nangia from Baylor College of Medicine.

The end point of the study was to determine the ratio of patients with hair loss, described as "0 points" (no hair loss) or as "1 point" (less than 50% of hair was lost) and patients whose hair loss in the study was described as "2 points" (more than 50% of hair was lost). The work was completed ahead of schedule when an interim analysis of 95 participants from the experimental and 47 from the control groups demonstrated statistically significant advantages of using the device.

It turned out that the intensity of hair loss was 50.5% of the study participants from the first group who received 0 or 1 point, while no such results were recorded in the control group. An additional analysis of the relationship between the nature of chemotherapy and the effectiveness of the device showed that hair loss with an intensity of 0 points or 1 point occurred in 65.1% of cases among those receiving taxanes, and in 21.9% of cases among those receiving anthracyclines.

Even after the advent of targeted therapies, chemotherapy remains the cornerstone of treatment for many breast cancer patients. It plays an important role in improving survival in the early stages, but has a number of well-known side effects.

One of the most unpleasant such effects, especially for women, is drug–induced alopecia, which develops in most patients treated with traditional chemotherapeutic drugs. Although some products affect hair loss to a lesser extent, they cannot be called completely harmless in this regard. Some breast cancer patients find alopecia so frightening that they refuse treatment that could save their lives.

"Hair loss is a visible evidence of the presence of cancer. She identifies a person as a cancer patient, and many women are extremely upset by this circumstance," explains Dr. Harold Burstein from the Dana–Farber Cancer Institute.

In recent years, a number of devices have been developed designed to prevent or reduce hair loss due to chemotherapy. However, such devices are distributed mainly outside the United States, mainly due to concerns that their use may increase the risk of developing metastases in the scalp.

Both cancer cells and the cells responsible for hair growth divide quickly, and chemotherapy affects all types of rapidly dividing cells without making a distinction between them. Cooling leads to narrowing of blood vessels and hair follicles on the surface of the head, reducing the rate of cell division and protecting them from the effects of chemotherapeutic agents. However, circulating cancer cells may accidentally end up in the cooled area and eventually lead to the appearance of metastases.

The world experience of using head cooling devices in oncology already counts hundreds of thousands of patients, while there is no evidence of an increase in the risk of metastasis yet. The effectiveness of cooling the head in order to reduce hair loss can be judged by the results of a meta-analysis of 53 studies on this issue published in the Annals of Oncology, with the oldest of the works dating back to 1973. Significant improvement was achieved by the authors of 6 out of 7 randomized trials included in the review. In 13 out of 14 non-randomized studies, the authors noted that the use of cooling is advisable in the presence of indications. The remaining 35 studies were uncontrolled, but their results are generally comparable with the results of the above-mentioned controlled studies: positive effects were noted by the authors of 31 out of 35 studies.

Breast cancer chemotherapy using taxanes or anthracyclines is widely used in Of Russia. In some Russian cancer clinics, patients also undergo head cooling procedures in order to reduce hair loss. Now, summarizing the experience of the USA and Europe, it can be argued that this intervention is not accompanied by an increased risk of metastasis and can really help in solving the problem of drug-induced alopecia.

Portal "Eternal youth" http://vechnayamolodost.ru  13.12.2016

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