Cold thermal injury from cold caps used for the prevention of chemotherapy-induced alopecia
Cold thermal injury from cold caps used for the prevention of chemotherapy-induced alopecia
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DOI：
10.1007/s10549-016-3799-7
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发表时间：
2016-06-01
影响因子：
3.8
通讯作者：
Lacouture, Mario E.
中科院分区：
文献类型：
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作者：
Belum, Viswanath Reddy;Silva, Giselle de Barros;Lacouture, Mario E.
使用头皮冷却来预防化疗引起的脱发（CIA）正在增加。在细胞毒性化疗之前、期间和之后，将冷帽放置在头皮的毛发承载区域上不同的时间段。尽管尚未报告，但不当的应用程序可能导致不良事件（AE）。目前，没有证据为基础的头皮冷却协议，也没有监管机构监督他们的使用。为了报告冷热损伤（冻伤）的发生在头皮上，使用冷帽预防CIA。我们确定了四名患者谁开发冷热损伤头皮后，应用冷帽。分析病历以检索人口统计学和临床特征。我们的患者中的冷热损伤的严重程度为1/2级，通过局部干预和中断冷帽使用得到改善，尽管3例患者随后发生1级持续性脱发。然而，在这种情况下此类损伤的真实发生率仍然未知。冷热损伤可能是罕见且可预防的AE，可能是由于冷帽使用期间器械应用程序不当所致。尽管这些不良事件的严重程度通常为轻度至中度，但长期后遗症（例如，永久性脱发和疤痕）或需要停止使用冷帽，尚不清楚。需要进行前瞻性研究，以进一步阐明风险和标准化医疗保健提供方法，并改善患者/支持/医疗保健提供者的教育。
The use of scalp cooling for the prevention of chemotherapy-induced alopecia (CIA) is increasing. Cold caps are placed onto the hair-bearing areas of the scalp for varying time periods before, during, and after cytotoxic chemotherapy. Although not yet reported, improper application procedures could result in adverse events (AEs). At present, there are no evidence-based scalp cooling protocols, and there is no regulatory oversight of their use.To report the occurrence of cold thermal injury (frostbite) on the scalp, following the use of cold caps for the prevention of CIA.We identified four patients who developed cold thermal injuries on the scalp following the application of cold caps. Medical records were analyzed to retrieve the demographic and clinical characteristics.The cold thermal injuries in our patients were grade 1/2 in severity and improved with topical interventions and interruption of cold cap use, although grade 1 persistent alopecia ensued in 3 patients. The true incidence of such injuries in this setting, however, remains unknown.Cold thermal injuries are likely infrequent and preventable AEs that may result from improper device application procedures during cold cap use. Although these untoward events are usually mild to moderate in severity, the potential occurrence of long-term sequelae (e.g., permanent alopecia and scarring) or the need to discontinue cold cap use, are not known. Prospective studies are needed to further elucidate the risk and standardize healthcare delivery methods, and to improve patient/supportive/healthcare provider education.