THE POSITIVE IMPACTS OF SCALP COOLING AS A TECHNOLOGY TO PREVENT CHEMOTHERAPY-INDUCED ALOPECIA: A PROSPECTIVE COHORT IN PUBLIC HEALTH SERVICE

Introduction: Chemotherapy(CT)-induced alopecia is feared side effects by patients (pts). The only method proven effective in preventing hair loss is the use of a scalp cooling (SC) during CT sessions by the contraction of blood vessels reduces the damage of CT to hair follicles. It is an innovative technology that is nationally limited to some private cancer centers and scarce in public service. Objective: To evaluate the effectiveness, adherence and self-satisfaction of the use of SC in the prevention of CT-induced alopecia in breast cancer (BC) pts treated in a public health system hospital. Method: Prospective observational multidisciplinary cohort carried out between February 2021 and June 2022 in which BC pts were evaluated according to alopecia using CTCAE, CT schema, adhesion to SC protocol, satisfaction with the use of SC and the reason for the use and interruption of SC. An aleatory subgroup of BC pts answered a survey regarding self-image related to hair and breast, expectations and experience to SC and also FACT-G quality of life questionnaire beginning of QY until the 3rd cycle and at the end of CT sessions. Results: All of 110 pts included were women and the median age was 55 years old. About half of pts (47%) used anthracycline CT and the other half taxane based CT. A total of 31% had no significant hair loss and 57% of pts lost less than 50% of hair. Only 12% of pts had grade 2 alopecia – lost more than 50% of hair. Regarding pts self-reported satisfaction, 32% (n=32) considered themselves very satisfied with the results of the SC, 47% (n=47) satisfied and 10% (n=10) partially satisfied. The dissatisfaction rate was only 11% (n=11) and intimated related to the degree of alopecia. Moreover, about 75% of pts adhere to SC protocol and extra timing after CT infusion were the most relevant complaint. About 80% of pts decided to use SC to preserve her self-image and classified the SC as a tolerable method. FACT-G results demonstrated a 85% of patients reported feeling little or nothing sick; 85% have a good relationship with friends; 60% felt little or nothing sad; 65% are very satisfied with the quality of life. Conclusion: Our study demonstrates the positive impacts of SC as an effective method to avoid CT-related hair loss and suggest that it is feasible even in the public system. BC pts were in the vast majority satisfied and tolerated the use of SC. We suggest also that the use of SC can help BC pts maintain her quality of life during CT.