Chemotherapy-induced hair loss is a common and distressing side effect of cancer therapy and presents a major supportive care challenge. Scalp cooling has been shown to be effective for preventing hair loss for many patients. Although the mechanism for its effect is not certain, it is hypothesized that cooling of the scalp causes cutaneous vasoconstriction, which reduces blood flow to the hair follicles thereby as well as the uptake of chemotherapeutic agents. Cooling also reduces biochemical activity, and this may make hair follicles less susceptible to the effects of chemotherapy. Two 2017 systematic reviews1 have documented the efficacy of scalp cooling for many patients with solid tumors who are receiving various types of chemotherapy, and long-term safety data are now available2
Several members of MASCC’s Skin Toxicities Study Group have been leading the way in collecting efficacy and safety data and developing information channels for both patients and physicians. CHILL stands for Cancer-related Hair Loss, International Leadership and Linkage. Its Executive Board includes MASCC members Corina van den Hurk (The Netherlands), Annie Young (United Kingdom), Frances Boyle (Sydney, Australia), and Mario Lacouture (United States). Other members of the Skin Toxicities Study Group have been involved in CHILL and projects related to hair loss and scalp cooling.
In June, CHILL announced a new initiative, a registry for collecting evidence-based data about scalp cooling in order to provide patient information and clinical guidance. The initiative was launched at the 2017 MASCC/ISOO Annual Meeting in Washington, DC. The CHILL Registry3 makes communication and global research accessible to all healthcare professionals interested in using scalp cooling with their chemotherapy patients. The registry collects data about severity of hair loss with and without scalp cooling, and the platform facilitates the exchange of information among patients, physicians, nurses, and researchers.
The data will be used to establish the best clinical practices, ensuring maximum effectiveness of scalp cooling and minimizing chemotherapy-induced hair loss. A new website, https://www.scalpcooling.org/, serves as a global hub for patients and care providers who are looking for information about hair loss and scalp cooling. The site also contains a decision aid that shows the chances of hair loss with and without scalp cooling.
Corina van den Hurk has said that “The launch of the CHILL Registry is a significant step forward as we work together to develop best practices in supportive care.” According to Annie Young, “Patient interest in scalp cooling is universal. This is a treatment that our patients want to use, and we need to ensure that best practices are developed to optimize success and also work to make it accessible to all.”
Besides helping to set up the CHILL Registry, members of the Skin Toxicities Study Group have collaborated on Annual Meeting presentations in Adelaide and Washington, a revised chapter on hair loss for the Second Edition of the MASCC Textbook on Cancer Supportive Care and Survivorship, and a proposed workshop for 2018 Meeting in Vienna. The group is also developing a questionnaire on the impact of chemotherapy-induced alopecia.
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1Scalp Cooling: A Literature Review of Efficacy, Safety, and Tolerability for Chemotherapy- Induced Alopecia. Ross M, Fischer-Cartlidge E. Clin J Oncol Nurs. 2017 Apr 1;21(2): 226-233. Scalp hypothermia as a preventative measure for chemotherapy-induced alopecia: a review of controlled clinical trials. Shah VV, Wikramanayake TC, DelCanto GM, van den Hurk C et al. J Eur Acad Dermatol Venereol. 2017 Oct 4.
2Scalp Cooling Safe, Long-term European Data Show, Medscape.
3The CHILL Registry is funded by Dignitana, maker of The DigniCap® Scalp Cooling System and by Paxman, maker of the Paxman Scalp Cooling System.
