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年全球诊断出超过200万例新病例。现代疗法，包括化疗和抗激素治疗，在早期阶段成功使用的生存率超过80%。这些抗激素（内分泌）疗法现在建议长达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。高达25%的人因为癌症治疗导致女性荷尔蒙减少而脱发。此外，多达三分之二的化疗患者在化疗后从未完全长出头发。这可能是一个心理上的毁灭性事件。可用的治疗方法包括米诺地尔，一种增加头皮血液供应的局部疗法，已经显示出一些改善激素治疗相关的脱发，以及血压药物安体舒通。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科的伤口支持，面部年轻化，也脱发。血小板（血小板）是血液的一种成分，含有高浓度的具有抗炎和刺激生长作用的蛋白质。PRP是从患者的血液离心后获得的。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着变化，即使妇女已经接受了米诺地尔或全身治疗。 绝经期脱发与癌症患者抗激素治疗脱发的原因相似，这表明PRP可能是一种适合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。将纳入EIA和pCIA各实体的14例患者。患者的一半头皮将接受PRP注射，而另一半头皮将不接受治疗，作为研究对照。PRP以网格状模式每4周注射一次到头皮的相同一半，持续12周。将在PRP开始后第12周和第24周评估治疗疗效。还将评估对生活质量的影响。24周后，如果看到益处，患者可以交叉到他们头皮未治疗侧的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.