Криопрофилактика алопеции, индуцированной химиотерапией у онкобольных

Противоопухолевая химиотерапия вызывает анагеновую алопецию путем раннего апоптоза кератиноцитов вфолликуле. Одним из наиболее эффективных методов профилактики цитотоксической алопецией является система охлаждения кожи волосистой части головы. Суть метода заключается в использовании охлаждающих материалов в момент введения химиотерапевтических препаратов для возникновения вазоконстрикции в области волосистой части головы, что в свою очередь ведет к снижению кровотока и лимфотока уфолликулов и вызывает уменьшение концентрации химиопрепарата в области охлаждения. В обзоре представлены актуальные данные по криопрофилактике алопеции, индуцированной химиотерапией, у пациентов с неметастазирующим раком молочной железы. Эффективность метода оценивалась как выпадение волос менее 50% и варьирует в средних пределах 50–70%, однако зависит от режима химиотерапии, времени экспозиции охлаждения кожи головы ииндивидуальных особенностей пациента. Самые эффективные показатели профилактики анагеновой алопеции были у пациентов, принимающих монотерапию таксанами. Среди неблагоприятных эффектов пациенты отмечали ощущения холода, головокружение, болезненность кожи головы и лица. Были изучены преимущества и недостатки метода.

1. Огнерубов Н.А., Барсуков С.В. Гипотермия кожи головы для профилактики алопеции, индуцированной химиотерапией при раке молочной железы. Современная онкология. 2023. Т. 25. № 4. С. 513–517. DOI: 10.26442/18151434.2023.4.202549

2. Silva G.B., Ciccolini K., Donati A., Hurk C.V.D. Scalp cooling to prevent chemotherapy-induced alopecia. An Bras Dermatol. 2020. Vol. 95. N5. P. 631–637. DOI: 10.1016/j.abd.2020.03.005. Epub 2020 Jun 16. PMID: 32622629; PMCID: PMC7563013.

3. Полежаева И. С., Старцева Ж.А., Гольдберг В. Е., Попова Н.О. Опыт применения гипотермии волосистой части кожи головы для профилактики алопеции при проведении химиотерапии. Сибирский онкологический журнал. 2017. Т. 16. № 2. С. 66–70. DOI: 10.21294/18144861 2017 16 2 66 70. EDN YQRKBV.

4. Amarillo D., de Boni D., Cuello M. Chemotherapy, Alopecia, and Scalp Cooling Systems. Actas Dermosifiliogr. 2022. Vol. 113. N3. P. 278–283. English, Spanish. DOI: 10.1016/j.ad.2021.09.003. Epub 2021 Oct 12. PMID: 35526920.

5. Dunnill C.J., Al-Tameemi W., Collett A., Haslam I.S., Georgopoulos N.T. A Clinical and Biological Guide for Understanding Chemotherapy-Induced Alopecia and Its Prevention. Oncologist. 2018. Vol. 23. N1. P. 84–96. DOI: 10.1634/theoncologist.2017–0263. Epub 2017 Sep 26. PMID: 28951499; PMCID: PMC5759815.

6. Shin H., Jo S.J., Kim D.H., Kwon O., Myung S.K. Efficacy of interventions for prevention of chemotherapy-induced alopecia: a systematic review and meta-analysis. Int J Cancer. 2015. Vol. 136. N5. P. E442–54. DOI: 10.1002/ijc.29115. Epub 2014 Aug 11. PMID: 25081068.

7. Lacouture M.E., Sibaud V., Gerber P.A., van den Hurk C., Fernández-Peñas P., Santini D., Jahn F., Jordan K.; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines*. Ann Oncol. 2021. Vol. 32. N2. P. 157–170. DOI: 10.1016/j.annonc.2020.11.005. Epub 2020 Nov 25. PMID: 33248228.

8. Boyle F.M. et al. (2018). Management of Alopecia Due to Cancer Therapies. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Cham. https://doi.org/10.1007/978 3 319 90990 5_38

9. Wang S., Yang T., Shen A., Qiang W., Zhao Z., Zhang F. The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer. 2021. Vol. 29. N11. P. 6943–6956. DOI: 10.1007/s00520 021 06188 8. Epub 2021 Apr 13. PMID: 33847828.

10. Rzepecki A.K., Cheng H., McLellan B.N. Cutaneous toxicity as a predictive biomarker for clinical outcome in patients receiving anticancer therapy. J Am Acad Dermatol. 2018. Vol. 79. N3. P. 545–555. DOI: 10.1016/j.jaad.2018.04.046. Epub 2018 May 4. PMID: 29733938.

11. Kang D., Kim I.R., Choi E.K., Im Y.H., Park Y.H., Ahn J. S., Lee J.E., Nam S. J., Lee H.K., Park J.H., Lee D.Y., Lacouture M.E., Guallar E., Cho J. Permanent Chemotherapy-Induced Alopecia in Patients with Breast Cancer: A 3-Year Prospective Cohort Study. Oncologist. 2019. Vol. 24. N3. P. 414–420. DOI: 10.1634/theoncologist.2018–0184. Epub 2018 Aug 17. PMID: 30120165; PMCID: PMC6519756.

12. Freites-Martinez A., Chan D., Sibaud V., Shapiro J., Fabbrocini G., Tosti A., Cho J., Goldfarb S., Modi S., Gajria D., Norton L., Paus R., Cigler T., Lacouture M.E. Assessment of Quality of Life and Treatment Outcomes of Patients With Persistent Postchemotherapy Alopecia. JAMA Dermatol. 2019. Vol. 155. N6. P. 724–728. DOI: 10.1001/jamadermatol.2018.5071. PMID: 30840033; PMCID: PMC6563563.

13. Freites-Martinez A., Shapiro J., Goldfarb S., Nangia J., Jimenez J.J., Paus R., Lacouture M.E. Hair disorders in patients with cancer. J Am Acad Dermatol. 2019. Vol. 80. N5. P. 1179–1196. DOI: 10.1016/j.jaad.2018.03.055. Epub 2018 Apr 14. PMID: 29660422; PMCID: PMC6186204.

14. Rossi A., Caterina Fortuna M., Caro G., et al. Monitoring chemotherapy-induced alopecia with trichoscopy. J Cosmet Dermatol. 2019. Vol. 18. N2. P. 575–80. DOI:10.1111/jocd.12687

15. Freites-Martinez A., Shapiro J., van den Hurk C., Goldfarb S., Jimenez J.J., Rossi A.M., Paus R., Lacouture M.E. Hair disorders in cancer survivors. J Am Acad Dermatol. 2019. Vol. 80. N5. P. 1199– 1213. DOI: 10.1016/j.jaad.2018.03.056. Epub 2018 Apr 14. PMID: 29660423; PMCID: PMC6186205.

16. Stoehr J.R., Kosche C., Choi J.N. Permanent chemotherapy-induced alopecia: awareness and attitudes among health care providers. Support Care Cancer. 2020. Vol. 28. N6. P. 2887–2890. DOI: 10.1007/s00520 019 05169 2. Epub 2019 Nov 19. PMID: 31745696.

17. Martín M, de la Torre-Montero JC, López-Tarruella S, et al. Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling. Breast Cancer Res Treat. 2018. Vol. 171. N3. P. 627–634. DOI: 10.1007/s10549 018 4855 2. Epub 2018 Jun 19. Erratum in: Breast Cancer Res Treat. 2018 Oct;171(3):635–636. DOI: 10.1007/s10549–018–4883-y. PMID: 29923063; PMCID: PMC6133184.

18. Wikramanayake TC, Haberland NI, Akhundlu A, et al. Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?. Curr Oncol. 2023. Vol. 30. N4. P. 3609–3626. DOI: 10.3390/curroncol30040275. PMID: 37185388; PMCID: PMC10137043.

19. Delgado Rodríguez J, Ramos-García V, Infante-Ventura D, et al. Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy-induced alopecia: A systematic review. Health Expect. 2023. Vol. 26. N2. P. 567–578. DOI: 10.1111/hex.13679. Epub 2022 Dec 30. PMID: 36585793; PMCID: PMC10010082.

20. Zhou T, Han S, Zhu Z, et al. Interventions for Preventing Chemotherapy-Induced Alopecia: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Cancer Nurs. 2021. Vol. 44. N6. P. E567-E577. DOI: 10.1097/NCC.0000000000000899. PMID: 33003120.

21. Saraswat N, Chopra A, Sood A, et al. A Descriptive Study to Analyze Chemotherapy-Induced Hair Loss and its Psychosocial Impact in Adults: Our Experience from a Tertiary Care Hospital. Indian Dermatol Online J. 2019. Vol. 10. N4. P. 426–430. DOI: 10.4103/idoj.IDOJ_471_18. PMID: 31334063; PMCID: PMC6615375.

22. Quesada S, Guichard A, Fiteni F. Cancer-Related Alopecia: From Etiologies to Global Management. Cancers (Basel). 2021. Vol. 13. N21. P. 5556. DOI: 10.3390/cancers13215556. PMID: 34771716; PMCID: PMC8583126.

23. Haque E, Alabdaljabar MS, Ruddy KJ, et al. Management of chemotherapy-induced alopecia (CIA): A comprehensive review and future directions. Crit Rev Oncol Hematol. 2020. Vol. 156. P. 103093. DOI: 10.1016/j.critrevonc.2020.103093. Epub 2020 Sep 22. PMID: 33070077.

24. Shen XF, Ru LX, Yao XB. Efficacy of scalp cooling for prevention of chemotherapy induced alopecia: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021. Vol. 25. N16. P. 5090–5103. DOI: 10.26355/eurrev_202108_26520. PMID: 34486683.

25. Skrok A, Bednarczuk T, Skwarek A, et al. The effect of parathyroid hormones on hair follicle physiology: implications for treatment of chemotherapy-induced alopecia. Skin Pharmacol Physiol. 2015. Vol. 28. N4. P. 213–225. DOI: 10.1159/000375319. PMID: 25721772.

26. Lacouture M.E., Dion H., Ravipaty S., et al. A phase I safety study of topical calcitriol (BPM31543) for the prevention of chemotherapy-induced alopecia. Breast Cancer Res Treat. 2021. Vol. 186. N1. P. 107–114. DOI: 10.1007/s10549 020 06005 6. Epub 2020 Nov 18. PMID: 33206291; PMCID: PMC8388155.

27. FDA. FDA Clears Expanded Use of Cooling Cap to Reduce Hair Loss During Chemotherapy. U.S. Food and Drug Administration. [дата обращения 07.12.24]. Available from: [https://www.fda.gov/news-events/ press-announcements/fda-clears-expanded-use-cooling-cap-reduce-hair-loss-during-chemotherapy]

28. Komen M.M., Smorenburg C.H., van den Hurk C.J., Nortier J.W. Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia. Oncologist. 2013. Vol. 18. N7. P. 885–91. DOI: 10.1634/theoncologist.2012–0332. Epub 2013 May 6. PMID: 23650021; PMCID: PMC3720643.

29. Shah V.V., Wikramanayake T. C., DelCanto G.M., van den Hurk C., Wu S., Lacouture M. E., Jimenez J.J. Scalp hypothermia as a preventative measure for chemotherapy-induced alopecia: a review of controlled clinical trials. J Eur Acad Dermatol Venereol. 2018. Vol. 32. N5. P. 720–734. DOI: 10.1111/jdv.14612. Epub 2017 Nov 24. PMID: 28976026; PMCID: PMC8127610.

30. Komen M.M.C., Smorenburg C.H., Nortier J.W.R., van der Ploeg T., van den Hurk C.J.G., van der Hoeven J.J.M. Results of scalp cooling during anthracycline containing chemotherapy depend on scalp skin temperature. Breast. 2016. Vol. 30. P. 105–110. DOI: 10.1016/j.breast.2016.09.007. Epub 2016 Sep 28. PMID: 27689316.

31. Carton E., Blas A.M., Perret C., Le Bihan M. Effectiveness of increasing the scalp cooling duration to prevent alopecia during adjuvant chemotherapy for breast cancer: a randomized pilot study. Support Care Cancer. 2024. Vol. 32. N7. P. 410. DOI: 10.1007/s00520–024–08579-z. PMID: 38839667; PMCID: PMC11153286.

32. van den Hurk C.J., Breed W.P., Nortier J.W. Short post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia. Support Care Cancer. 2012. Vol. 20. N12. P. 3255–60. DOI: 10.1007/s00520 012 1465 0. Epub 2012 Apr 27. PMID: 22539051.

33. Komen M.M., Breed W.P., Smorenburg C.H., van der Ploeg T., Goey S.H., van der Hoeven J.J., Nortier J.W., van den Hurk C.J. Results of 20- versus 45-min post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia. Support Care Cancer. 2016. Vol. 24. N6. P. 2735–41. DOI: 10.1007/s00520 016 3084 7. Epub 2016 Jan 25. PMID: 26805558.

34. Komen M.M.C., van den Hurk C. J.G., Nortier J.W.R., van der Ploeg T., Nieboer P., van der Hoeven J.J.M., Smorenburg C.H. Prolonging the duration of post-infusion scalp cooling in the prevention of anthracycline-induced alopecia: a randomised trial in patients with breast cancer treated with adjuvant chemotherapy. Support Care Cancer. 2019. Vol. 27. N5. P. 1919–1925. DOI: 10.1007/s00520 018 4432 6. Epub 2018 Sep 11. PMID: 30206728.

35. Nangia J., Wang T., Osborne C., et al. Effect of a Scalp Cooling Device on Alopecia in Women Undergoing Chemotherapy for Breast Cancer: The SCALP Randomized Clinical Trial. JAMA. 2017. Vol. 317. N6. P. 596–605. DOI: 10.1001/jama.2016.20939. PMID: 28196254.

36. Rugo H.S., Klein P., Melin S.A., et al. Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer. JAMA. 2017. Vol. 317. N6. P. 606–614. DOI: 10.1001/jama.2016.21038. PMID: 28196257; PMCID: PMC5639721.

37. Rubio-Gonzalez B., Juhász M., Fortman J., Mesinkovska N.A. Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review. Int J Dermatol. 2018. Vol. 57. N12. P. 1417–1424. DOI: 10.1111/ijd.13906. Epub 2018 Jan 29. PMID: 29377091.

38. Smetanay K., Junio P., Feißt M., et al. COOLHAIR: a prospective randomized trial to investigate the efficacy and tolerability of scalp cooling in patients undergoing (neo)adjuvant chemotherapy for early breast cancer. Breast Cancer Res Treat. 2019. Vol. 173. N1. P. 135–143. DOI: 10.1007/s10549 018 4983 8. Epub 2018 Sep 25. PMID: 30255454.

39. Munzone E., Bagnardi V., Campennì G., et al. Preventing chemotherapy-induced alopecia: a prospective clinical trial on the efficacy and safety of a scalp-cooling system in early breast cancer patients treated with anthracyclines. Br J Cancer. 2019. Vol. 121. N4. P. 325–331. DOI: 10.1038/s41416 019 0520 8. Epub 2019 Jul 15. PMID: 31303642; PMCID: PMC6738323.

40. Giarratano T., Frezzini S., Zanocco M., et al. Use of scalp cooling device to prevent alopecia for early breast cancer patients receiving chemotherapy: A prospective study. Breast J. 2020. Vol. 26. N7. P. 1296–1301. DOI: 10.1111/tbj.13711. Epub 2019 Dec 14. PMID: 31837103.

41. van den Hurk C. J., Peerbooms M., van de Poll-Franse L.V., Nortier J. W., Coebergh J.W., Breed W.P. Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients – results of the Dutch Scalp Cooling Registry. Acta Oncol. 2012. Vol. 51. N4. P. 497–504. DOI: 10.3109/0284186X.2012.658966. Epub 2012 Feb 6. PMID: 22304489.

42. Rugo H.S., et al. Clinical performance of the DigniCap system, a scalp hypothermia system, in preventing chemotherapy-induced alopecia. ASCO Meeting Abstr. 2015. Vol. 33. P. 9518.

43. Rugo H.S., Melin S.A., Voigt J. Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis. Breast Cancer Res Treat. 2017. Vol. 163. N2. P. 199–205. DOI: 10.1007/s10549 017 4185 9. Epub 2017 Mar 8. PMID: 28275922; PMCID: PMC5410200.

44. Rugo H.S., Voigt J. Scalp Hypothermia for Preventing Alopecia During Chemotherapy. A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Breast Cancer. 2018. Vol. 18. N1. P. 19–28. DOI: 10.1016/j.clbc.2017.07.012. Epub 2017 Aug 10. PMID: 28939291.

45. Kadakia K.C., Rozell S.A., Butala A.A., Loprinzi C. L. Supportive cryotherapy: a review from head to toe. J Pain Symptom Manage. 2014. Vol. 47. N6. P. 1100–15. DOI: 10.1016/j.jpainsymman.2013.07.014. Epub 2013 Nov 7. PMID: 24210702; PMCID: PMC4013268.

46. Heibloem R.E., Komen M.M.C., Ilozumba O.U.C., van den Hurk C.J.G. Minimal added value of wetting hair before scalp cooling to prevent chemotherapy-induced alopecia in cancer patients – results from the Dutch Scalp Cooling Registry. Support Care Cancer. 2023. Vol. 31. N5. P. 273. DOI: 10.1007/s00520 023 07687 6. PMID: 37067605.

47. Kanat O., Ertas H., Caner B. Platinum-induced neurotoxicity: A review of possible mechanisms. World J Clin Oncol. 2017. Vol. 8. N4. P. 329–335. DOI: 10.5306/wjco.v8.i4.329. PMID: 28848699; PMCID: PMC5554876.

48. Rossi A., Caro G., Fortuna M.C., Pigliacelli F., D’Arino A., Carlesimo M. Prevention and Treatment of Chemotherapy-Induced Alopecia. Dermatol Pract Concept. 2020. Vol. 10. N3. P. e2020074. DOI: 10.5826/dpc.1003a74. PMID: 32642317; PMCID: PMC7319796.

49. Marks D.H., Okhovat J.P., Hagigeorges D., Manatis-Lornell A.J., Isakoff S.J., Lacouture M.E., Senna M.M. The effect of scalp cooling on CIA-related quality of life in breast cancer patients: a systematic review. Breast Cancer Res Treat. 2019. Vol. 175. N2. P. 267–276. DOI: 10.1007/s10549 019 05169 0. Epub 2019 Feb 26. PMID: 30806923.

50. Carbognin L., Accetta C., Di Giorgio D., et al. Prospective Study Investigating the Efficacy and Safety of a Scalp Cooling Device for the Prevention of Alopecia in Women Undergoing (Neo) Adjuvant Chemotherapy for Breast Cancer. Curr Oncol. 2022. Vol. 30;29(10). P. 7218–7228. DOI: 10.3390/curroncol29100569. PMID: 36290846. PMCID: PMC9600590.