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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Scalp cooling is a technique for reducing chemotherapy-induced hair loss&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It has been theorized that scalp cooling has two mechanisms of action&#58; reducing uptake of chemotherapeutic agents in the hair follicles through local vasoconstriction and decreasing the metabolic activity of the follicles&#46; The main concern regarding the use of scalp cooling devices is the possibility that this technique could increase the risk of cutaneous metastases&#46; Most studies assessing the efficacy and safety of this technique have been carried out in patients with breast cancer&#44; in whom no increased risk of cutaneous metastases has been demonstrated&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;2</span></a> The evidence supporting the use of scalp cooling in patients with other solid tumors&#44; such as prostate and ovarian cancer&#44; is less robust&#46; Scalp cooling is not recommended for diseases with a high tumor burden&#44; such as hematologic malignancies&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A nonnegligible number of women refuse chemotherapy because of the risk of hair loss&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Therefore&#44; it makes sense to use interventions that reduce the comorbidity associated with these systemic treatments&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Two recent clinical studies in women with breast cancer have confirmed the utility of scalp cooling with automatic devices&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In both studies&#44; scalp cooling was associated with a significant decrease in hair loss in approximately 50&#37; of the women studied&#46; Five percent of patients who used a scalp cooling device did not experience any hair loss&#46; It should be noted that in the observational study hair loss was self-reported and the patients were not taking anthracyclines&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In the clinical trial&#44; alopecia assessments were carried out by a blinded researcher and patients received anthracycline-based chemotherapy&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In the cohort study&#44; patients who used a scalp cooling system had better scores regarding perception of hair loss&#44; dissatisfaction associated with hair loss&#44; and feelings of attractiveness 1 month after chemotherapy&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In the clinical trial&#44; no significant differences were found in patients&#8217; quality of life&#44; although the questionnaire used in the study has not been validated for the assessment of the impact of alopecia on quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding the safety of scalp cooling interventions&#44; reports of local side effects&#8212;mainly local discomfort and headache&#8212;are rare&#46; No scalp metastases were found in patients who underwent the procedure in either of the aforementioned studies&#46; In the nonexperimental study&#44; 2&#46;8&#37; of patients discontinued the procedure due to low tolerance of cold&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However&#44; 10&#37; of patients discontinued chemotherapy because of hair loss&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Finally&#44; regarding the cost of providing this procedure through the national health system&#44; it is worth noting that 2 other interventions that aim to improve quality of life&#8212;breast reconstruction after mastectomy and areolar micropigmentation&#8212;are also paid for by Spain&#39;s public system&#46; The scalp cooling devices used in the cited studies have a cost per patient of between &#36;1500 and &#36;3000&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; scalp cooling is a technique that should be considered for the prevention of chemotherapy-induced hair loss in patients with breast cancer&#46;</p></span>"
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Resident's Forum
RF-Scalp Cooling
FR-Enfriamiento del cuero cabelludo
O.M. Moreno-Arrones
Corresponding author
o.m.m.arrones@gmail.com

Corresponding author.
, D. Saceda-Corralo, S. Vañó-Galván
Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Scalp cooling is a technique for reducing chemotherapy-induced hair loss&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It has been theorized that scalp cooling has two mechanisms of action&#58; reducing uptake of chemotherapeutic agents in the hair follicles through local vasoconstriction and decreasing the metabolic activity of the follicles&#46; The main concern regarding the use of scalp cooling devices is the possibility that this technique could increase the risk of cutaneous metastases&#46; Most studies assessing the efficacy and safety of this technique have been carried out in patients with breast cancer&#44; in whom no increased risk of cutaneous metastases has been demonstrated&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;2</span></a> The evidence supporting the use of scalp cooling in patients with other solid tumors&#44; such as prostate and ovarian cancer&#44; is less robust&#46; Scalp cooling is not recommended for diseases with a high tumor burden&#44; such as hematologic malignancies&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A nonnegligible number of women refuse chemotherapy because of the risk of hair loss&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Therefore&#44; it makes sense to use interventions that reduce the comorbidity associated with these systemic treatments&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Two recent clinical studies in women with breast cancer have confirmed the utility of scalp cooling with automatic devices&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In both studies&#44; scalp cooling was associated with a significant decrease in hair loss in approximately 50&#37; of the women studied&#46; Five percent of patients who used a scalp cooling device did not experience any hair loss&#46; It should be noted that in the observational study hair loss was self-reported and the patients were not taking anthracyclines&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In the clinical trial&#44; alopecia assessments were carried out by a blinded researcher and patients received anthracycline-based chemotherapy&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In the cohort study&#44; patients who used a scalp cooling system had better scores regarding perception of hair loss&#44; dissatisfaction associated with hair loss&#44; and feelings of attractiveness 1 month after chemotherapy&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In the clinical trial&#44; no significant differences were found in patients&#8217; quality of life&#44; although the questionnaire used in the study has not been validated for the assessment of the impact of alopecia on quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding the safety of scalp cooling interventions&#44; reports of local side effects&#8212;mainly local discomfort and headache&#8212;are rare&#46; No scalp metastases were found in patients who underwent the procedure in either of the aforementioned studies&#46; In the nonexperimental study&#44; 2&#46;8&#37; of patients discontinued the procedure due to low tolerance of cold&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However&#44; 10&#37; of patients discontinued chemotherapy because of hair loss&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Finally&#44; regarding the cost of providing this procedure through the national health system&#44; it is worth noting that 2 other interventions that aim to improve quality of life&#8212;breast reconstruction after mastectomy and areolar micropigmentation&#8212;are also paid for by Spain&#39;s public system&#46; The scalp cooling devices used in the cited studies have a cost per patient of between &#36;1500 and &#36;3000&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; scalp cooling is a technique that should be considered for the prevention of chemotherapy-induced hair loss in patients with breast cancer&#46;</p></span>"
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ISSN: 15782190
Original language: English
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