Dados do Resumo

Título

FEASIBILITY OF CRYOTHERAPY IN THE PREVENTION OF CHEMOTHERAPY-INDUCED ALOPECIA: PROTOCOLS, RESULTS, AND IMPLICATIONS FOR CLINICAL PRACTICE

Introdução

Chemotherapy-induced alopecia (CIA) is a common but reversible side effect characterized by varying degrees of hair loss caused by a single or combined chemotherapy regimens. This side effect can have a significant negative impact on the quality of life of patients. Understanding the feasibility and implementation of a CIA protocol should be part of continuous improvement efforts, contributing to the identification of gaps that may exist in the prevention of this toxicity.

Objetivo

To describe the acceptance, tolerance, and efficacy of scalp cryotherapy during infusion chemotherapy treatment in an outpatient unit over a one-year period.

Métodos

This retrospective study analyzed data from outpatient service records of patients undergoing protocols for breast, gynecological, skin, and lung cancers from May 2023 to May 2024. The rates of dropouts, the total number of scalp cryotherapy applications, and
chemotherapy protocols used were evaluated. The degree of alopecia was classified using the Common Terminology Criteria for Adverse Events (CTCAE) v4.

Resultados

From May 2023 to May 2024, 792 chemotherapy protocols were conducted with an indication for the use of scalp cryotherapy. A total of 190 (24%) patients participated in the scalp cryotherapy protocol. The evaluated protocols included Doxorubicin + Cyclophosphamide + Carboplatin and weekly Paclitaxel (ACdd + Carbo + Weekly Taxol), Docetaxel + Cyclophosphamide (TC), Carboplatin + Paclitaxel every 21 days (Carbo + Taxol), Docetaxel +Carboplatin + Trastuzumab + Pertuzumab (TCHP), and weekly Paclitaxel + Trastuzumab (TH). Of these patients, 82 (43%) completed the treatment with the device, with 38 (46%) of them experiencing Grade 1 alopecia. Meanwhile, 68 (36%) discontinued its use, with 29 (43%) of them experiencing Grade 2 alopecia, and 40 (21%) continued using it. The protocols with the highest dropout rates were ACdd (17 patients, 46%), with 12 (71%) discontinuing after Cycle 2; TC (25 patients, 42%), with 15 (60%) discontinuing after Cycle 1; and Carbo + Taxol (13 patients, 41%), with 9 (28%) discontinuing after Cycle 2.

Conclusões

This retrospective study highlights the identification of dropout rates related to chemotherapy protocols and the
degree of alopecia. Although many patients completed treatment without severe alopecia (Grade 1), the ACdd + Carbo + Weekly Taxol protocol exhibited the highest dropout rate, indicating challenges in maintaining scalp cryotherapy during treatment, possibly due to issues associated with the tolerance or acceptance of the procedure.

Palavras Chave

scalp cooling; alopecia; chemotherapy