SCALP COOLING BY COLD AIR FOR THE PREVENTION OF CHEMOTHERAPY INDUCED ALOPECIA
A new system is described for cooling
the scalp with cold air in order to prevent chemotherapy-induced alopecia. Compressed
air was cooled by means of vortex tube built into a hair-drier cap. This system
reduced the blood flow in the scalp to 35%, the surface temperature to 14.2
degrees C and the intradermal temperature at hair follicle level to 29.2 degrees
C. The low temperature could be kept constant for at least one hour of cooling.
By means of comparison, with cryogel packs the lowest epidermal temperature
attained was 17.9 degrees C; moreover, once this was reached after 10 min, it
rapidl rose again to 20.6 degrees C after 40 min. Forty-eight patients receiving
cytostatic treatment for breast cancer were subjected to scalp cooling with
the cold air system, starting 15 min before chemotherapy and lasting for 90
min. With the system set at an air temperature of -12 degrees C, the treatment
was well tolerated. Of the 13 patients treated with 40 mg/m2 doxorubicin in
combination with other cytostatics, 6 had hair loss less than WHO grade 3, in
contrast to 1 of 4 patients given cryogel packs. However, patients treated with
epirubicin at 75 mg/m2 all showed grade 3 hair loss in spite of air cooling.
In view of the possibility of achieving and maintaining low scalp temperatures,
the cold air system is to be preferred to cryogel packs. Whether better clinical
results may be obtained with cooling for longer periods and/or to lower temperatures
remains to be determined.
Hillen HF, Breed WP, Botman CJ
Department of Internal Medicine, Catharina Hospital, Eindhoven.
Neth J Med; 37(5-6):231-5 1990