A pilot study of the clinical efficacy of platelet-rich plasma (PRP) for the treatment of endocrine therapy-induced alopecia (EIA) and permanent chemotherapy-induced alopecia (pCIA) in breast cancer patients.

乳腺癌是女性中最常见的癌症，2018年全球新确诊病例超过200万例。包括化疗和抗激素治疗在内的现代治疗方法在早期成功使用，生存率超过80%。这些抗激素（内分泌）疗法现在被推荐长达5-10年。因此，长期的副作用，如脱发（脱发）大大损害了这些患者的生活质量。8%的患者因为脱发而停止激素治疗。多达25%的人因为癌症治疗导致的女性荷尔蒙减少而脱发。此外，多达三分之二接受化疗的患者在化疗后再也没有完全长出头发。这可能是一个心理上毁灭性的事件。现有的治疗方法包括米诺地尔（minoxidil），这是一种局部治疗，可以增加头皮的血液供应，在激素治疗相关的脱发方面有一定的改善，还有降压药螺内酯（spironolactone）。然而，对米诺地尔或螺内酯无效的妇女需要进一步的治疗。富血小板血浆（PRP）最初用于骨科运动损伤，以加速恢复，但已越来越多地用于皮肤病学的伤口支持，面部年轻化和脱发。血小板（血小板）是血液中的一种成分，含有高浓度的具有抗炎和刺激生长作用的蛋白质。PRP是在患者血液离心后获得的。在绝经后脱发的妇女中，PRP注射显示出头发密度和厚度的显著变化，即使这些妇女已经接受了米诺地尔治疗或全身治疗。更年期导致的脱发与癌症患者因抗激素治疗导致的脱发的原因相似，这表明PRP可能是一种适合于患有这种疾病的乳腺癌患者的治疗方法。在这项初步研究中，我们希望用PRP治疗正在经历激素治疗（EIA）和化疗相关脱发（pCIA）的乳腺癌患者。EIA和pCIA各纳入14例患者。患者将在一半头皮上接受PRP注射，而另一半头皮不接受治疗，作为研究对照。PRP以网格状模式每4周注射一次到同一侧头皮，持续12周。治疗效果将在PRP开始后的第12周和24周进行评估。对生活质量的影响也将进行评估。24周后，如果看到效果，患者可以对未经治疗的一侧头皮进行PRP治疗。

Breast cancer is the most common cancer among women, with over 2 million new cases diagnosed worldwide in 2018. Modern therapies, consisting of chemotherapy and anti-hormonal therapy, are successfully used with a survival rate of greater than 80% in early stages. These anti-hormonal (endocrine) therapies are now recommended for as long as 5-10 years. Therefore, long-term side effects such as hair loss (alopecia) substantially compromise the quality of life in these patients. 8% of patients discontinue hormone therapy because of hair loss. Up to 25% suffer from hair loss because of the reduction of female hormones caused by the cancer treatment. Also, up to two thirds of patients treated with chemotherapy never fully grow back their hair afterwards. This can be a psychologically devastating event.Available treatments include minoxidil, a topical therapy that increases blood supply to the scalp, which has shown some improvement in hormone therapy-related hair loss, and the blood pressure medication spironolactone. There is, however, a need for further therapies for women who do not respond to minoxidil or spironolactone.Platelet Rich Plasma (PRP) was first used in orthopedic sports injuries to speed up recovery but has been increasingly used in dermatology for wound support, facial rejuvenation, and also hair loss. Platelets (thrombocytes) are a component of the blood that contains a high concentration of proteins with anti-inflammatory and growth-stimulating effects. PRP is obtained after blood centrifugation from the patient.In women with postmenopausal hair loss, PRP injections have shown a significant change in hair density and thickness even if the women had already received treatment with minoxidil or systemic therapy. Hair loss due to menopause resembles the cause of hair loss due to anti-hormonal therapy in cancer patients and suggests that PRP may be a suitable treatment for breast cancer patients suffering from this condition.In this pilot study, we want to treat breast cancer patients, who are experiencing hormone therapy- (EIA) and chemotherapy-related hair loss (pCIA), with PRP. 14 patients of each entity, EIA and pCIA, will be included. The patients will receive PRP injections on one half of their scalp whereas the other half of the scalp will not be treated, to serve as a study control. PRP is injected to the same half of the scalp once every 4 weeks for 12 weeks in a grid-like pattern. Treatment efficacy will be assessed at weeks 12 and 24 after the start of PRP. The effect on the quality of life will also be assessed. After 24 weeks, patients can cross over to a PRP treatment of the untreated side of their scalp if a benefit is seen.