背景:化疗诱导的脱发(CIA)是化疗的常见且情绪紧张的副作用,包括经常用于治疗妇科癌症的紫杉烷药物。头皮体温过低,也被称为“冷帽”,是一种可能的方法来预防严重的A,主要在乳腺癌人群中进行研究。
目的:收集有关接受紫杉烷化疗的癌症患者头皮低体温的现有数据,以研究其在妇科癌症人群中的应用。
方法:MEDLINE,Embase,CINAHL,ClinicalTrials.gov,和Cochrane在2023年1月31日被搜索。
方法:全文报告了接受紫杉烷类化疗的患者头皮低体温的结果。
方法:将二项式比例求和,和随机效应荟萃分析。
结果:来自1424条记录,我们纳入了31项研究,代表14个不同的国家。只有5项研究包括妇科癌症患者。我们提取了<50%脱发患者的转归比例。在2179名患者中,据报道,60.7%的人脱发<50%(荟萃分析:60.6%,95%置信区间[CI]54.9-66.1%)。在仅报道紫杉烷化疗的28项研究中,<50%的脱发率为60.0%(荟萃分析:60.9%,(95%CI:54.9-66.7%)。在比较研究中,与未接受头皮低温治疗的患者相比,接受头皮低温治疗的患者的脱发明显较少(49.3%vs0%,脱发<50%;OR40.3,95%CI:10.5-154.8).在接受紫杉醇的患者中,头皮冷却达到<50%的脱发(67.7%;荟萃分析69.9%,95%CI64.1-75.4%)和多西他赛(57.1%;荟萃分析60.5%,95%CI50.0-71.6%)。患者对头皮冷却满意度的荟萃分析发现,满意率为78.9%(95%CI69.1-87.4%)。
结论:头皮亚低温可能是减少紫杉烷化疗引起的部分CIA病例的有效方法,尤其是紫杉醇。需要做更多的试验来确定头皮低温对妇科癌症患者的确切影响。
BACKGROUND: Chemotherapy-induced
alopecia (CIA) is a common and emotionally-taxing side effect of chemotherapy, including taxane agents used frequently in treatment of gynecologic cancers. Scalp hypothermia, also known as \"cold caps\", is a possible method to prevent severe CIA, studied primarily in the breast cancer population.
OBJECTIVE: To compile existing data on scalp hypothermia in cancer patients receiving taxane chemotherapy in order to investigate its application to the gynecologic cancer population.
METHODS: MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and Cochrane were searched through January 31, 2023.
METHODS: Full-text manuscripts reporting on the results of scalp hypothermia in patients receiving taxane-based chemotherapy.
METHODS: Binomial proportions were summed, and random-effects meta-analyses performed.
RESULTS: From 1424 records, we included 31 studies, representing 14 different countries. Only 5 studies included gynecologic cancer patients. We extracted the outcome of the proportion of patients with <50% hair loss. Among 2179 included patients, 60.7% were reported to have <50% hair loss (meta-analysis: 60.6%, 95% confidence interval [CI] 54.9-66.1%). Among the 28 studies reporting only on taxane-based chemotherapy, the rate of <50% hair loss was 60.0% (meta-analysis: 60.9%, (95% CI: 54.9-66.7%). In comparative studies, hair loss was significantly less in patients who received scalp hypothermia versus those who did not (49.3% versus 0% with <50% hair loss; OR 40.3, 95% CI: 10.5-154.8). Scalp cooling achieved <50% hair loss in patients receiving paclitaxel (67.7%; meta-analysis 69.9%, 95% CI 64.1-75.4%) and docetaxel (57.1%; meta-analysis 60.5%, 95% CI 50.0-71.6%). Meta-analysis on patient satisfaction in regard to scalp cooling found a satisfaction rate of 78.9% (95% CI 69.1-87.4%).
CONCLUSIONS: Scalp hypothermia may be an effective method to reduce some cases of CIA due to taxane chemotherapy, especially paclitaxel. More trials need to be done to determine the precise effects of scalp hypothermia in gynecologic cancer patients.