Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients - Results of the Dutch Scalp Cooling Registry

Figures & data

Table I. Result of scalp cooling according to patient and scalp cooling characteristics (n = 1411).

Characteristics	All patients (%)	No head cover/all (%)	p-value
Overall	1411 (100)	709/1411 (50)
Age group			0.02
≤ 44 (n = 287)	287 (21)	124/287 (43)
45–54 (n = 492)	492 (35)	269/492 (55)
55–64 (n = 413)	413 (30)	207/413 (50)
65 ≥ (n = 201)	201 (14)	95/201 (47)
Missing	18
Gender			< 0.0001
Male	50 (4)	40/50 (80)
Female	1357 (96)	665/1357 (49)
Missing	4
Cancer			< 0.0001
Breast	1216 (86)	598/1216 (49)
Female genital cancer	65 (5)	30/65 (46)
Gastro-intestinal/colorectal	63 (4)	25/63 (40)
Lung	19 (1)	15/19 (79)
Prostate	27 (2)	27/27 (100)
Other	16 (1)	12/16 (75)
Missing	5
Chemotherapy setting			0.0008
Adjuvant	979 (71)	460/979 (47)
Palliative	404 (29)	230/404 (57)
Missing	28
Chemotherapy ever before			0.007
Yes	176 (12)	105/176 (60)
No	1235 (88)	603/1235 (49)
Hair characteristics
Dyed			0.8
Yes	131 (9)	64/131 (49)
No^a	1280 (91)	644/1280 (50)
Waved			1.0
Yes	42 (3)	21/42 (50)
No^a	1369 (97)	687/1369 (50)
Coloured			0.2
Yes	461 (33)	219/461 (48)
No^a	950 (67)	489/950 (51)
Length			0.02
< 5 cm	379 (30)	210/379 (55)
> 5 cm	864 (70)	416/864 (48)
Missing	168
Quantity			0.1
Small	60 (5)	38/60 (63)
Medium	597 (48)	294/597 (49)
Large	587 (47)	289/587 (49)
Missing	167
Type of hair			0.07
African	11 (1)	4/11 (36)
Asian	40 (3)	13/40 (33)
West-European	1160 (93)	596/1160 (51)
South-European	39 (3)	17/39 (44)
Missing	161
Wetting hair before scalp cooling by
Dampen hair			0.8
Yes	182 (13)	93/182 (51)
No^a	1229 (87)	615/1229 (50)
Use hair conditioner			0.9
Yes	77 (5)	39/77 (51)
No^a	1334 (95)	669/1334 (50)

^a’No’ includes missings.

Table II. Head cover use during the last scalp cooling session according to type of chemotherapy.

Chemotherapy and planned dosage (mgr/m^2)^a	No head cover/total (%)	Median infusion time (min.) (SD/min/max)	Number of sessions planned^d
A60C600 (AC)	29/74 (39)	30 (13/10/90)	4
A60C600/D100^b (ACD)	10/16 (63)	20 (11/10/40)/60 (0/60/60)	4/4
ACT Overall	20/50 (40)
A60C600/T80^b (ACT80)	14/29 (48)	30 (15/10/75)/60 (31/60/180)	4/12
A60C600/T175^b (ACT175)	6/21 (29)	30 (22/20/120)/180 (0/180/180)	4/4
D75A50C500 (TAC)	5/66 (8)	90 (14/45/135)	6
D Overall^f	87/120 (73)
D75	31/33 (94)	60 (0/60/60)	n.a.
D100	27/44 (61)	60 (8/60/90)	n.a.
D75combi^c	21/33 (64)	105 (26/60/150)	n.a.
F500A50C500 (FAC)	21/39 (54)	45 (13/25/90)	5
FEC Overallf	371/752 (56)
F500E50 - 70C500 (FE50 - 70C)	22/38 (58)	45 (9/25/75)	5
F500/600E75 - 85C500/600 (FE75 - 85C)	16/32 (50)	45 (10/25/60)	5
F500E90C500 (FE90C)	292/558 (52)	45 (16/15/120)	5
F500/600E100C500/600 (FE100C)	40/123 (33)	45 (14/15/90)	6
F500E100C500/D100^b (FE100CD)	22/46 (48)	60 (21/15/90)/60 (12/60/140)	3/3
TCarbo Overall^f	31/68 (46)
T70 - 100Carbo	9/12 (75)	120 (31/90/210)	n.a.
T175Carbo	20/52 (38)	210 (31/90/240)	6
T70 - 90	34/42 (81)	60 (28/60/180)	n.a.
Irino350	12/42 (29)	60 (24/30/90)	n.a.
Other^e	49/64 (77)
Total	709/1411 (50)

A: doxorubicine; Carbo: carboplatin; C: cyclophosphamide; D: docetaxel; E: epirubicine; F: 5-fluorouracil; Irino: irinotecan T: paclitaxel. All 3-weekly schemes, with exception of /T80 and T70 - 90.

^aDosage other/missing, but included in multivariate analyses: TAC n = 1, FAC n = 4, FECD n = 6, T n = 2, Irino n = 5.

^bSequential scheme.

^cD combi: D combined with Cyclophosphamide, Capecitabine, Carboplatin, Gemcitabine, Methotrexaat, Myocet or Xeloda.

^dAccording to Dutch guidelines.

^eOther: < 10patients had a particular regimen with a specific dosage.

^fIncluding also other dosages than specified in this table.

Table III. Univariate and multivariate logistic regression analysis of all patients (n = 1411); odds of wearing no head cover during the last scalp cooling session (hc) and odds of WHO score 0 - 1 (who).

		Multivariate
Characteristics	Univariate OR (hc)	OR (hc)	95% CI	P-value	OR (who)
Age group (years)
≤ 44	1.0	1.0	–	–	1.0
45–54	1.5	1.3	(0.9–1.8)	0.1	1.2
55–64	1.2 (NS)	1.1	(0.7–1.5)	0.8	1.1
65 ≥	1.1 (NS)	0.6	(0.4–1.0)	0.04	0.8
Gender
Female	1.0	1.0	–	–	1.0
Male	4.2	6.3	(2.3–17.2)	0.0004	9.4^c
Chemotherapy
FEC	1.0	1.0	–	–	1.0
AC	0.7 (NS)	1.0	(0.6–1.7)	0.9	0.6
AC/D	1.7 (NS)	1.7	(0.5–5.2)	0.4	1.4
AC/T	0.7 (NS)	1.2	(0.6–2.5)	0.6	0.9
TAC	0.08	0.08	(0.03–0.2)	< 0.0001	0.04^c
D^b	2.7	2.0	(1.2–3.5)	0.01	1.6
FAC	1.2 (NS)	1.2	(0.6–2.5)	0.6	1.7
FEC/D	1.0 (NS)	0.9	(0.4–1.9)	0.8	1.1
TCarbo	0.9 (NS)	1.1	(0.5–2.4)	0.8	1.1
T	3.4	4.6	(2.1–10.2)	0.0002	4.3^c
Irino	0.4	0.3	(0.1–0.7)	0.004	0.2^c
Other	3.2	4.9	(2.3–10.3)	< 0.0001	4.3^c
Infusion time^a (minutes)
0–15	1.0	1.0	–	–	1.0
16–30	0.8 (NS)	1.2	(0.6–2.4)	0.6	0.9
31–45	1.0 (NS)	1.5	(0.8–2.8)	0.2	1.3
46–60	1.5 (NS)	1.8	(1.0–3.3)	0.07	1.5
61–90	0.7 (NS)	1.8	(0.9–3.7)	0.09	1.8
90 +	0.9 (NS)	1.6	(0.7–3.4)	0.2	1.2
Chemotherapy ever before	1.6	0.8	(0.6–1.3)	0.4	1.0
Dyed
No	1.0	1.0	–	–	1.0
Yes	1.0 (NS)	0.9	(0.6–1.3)	0.6	0.9
Waved
No	1.0	1.0	–	–	1.0
Yes	1.0 (NS)	1.2	(0.6–2.3)	0.7	1.1
Coloured
No	1.0	1.0	–	–	1.0
Yes	0.9 (NS)	0.9	(0.7–1.1)	0.3	1.0
Length
< 5 cm	1.0	1.0	–	–	1.0
≥ 5 cm	0.7	0.9	(0.7–1.1)	0.3	0.9
Quantity
Small	1.0	1.0	–	–	1.0
Medium	0.6	0.6	(0.4–1.2)	0.09	0.8
Large	0.6	0.7	(0.3–1.1)	0.2	0.9
Type of hair^a
West-European	1.0	1.0	–	–	1.0
South-European	0.7 (NS)	0.6	(0.3–1.3)	0.2	0.7
African	0.5 (NS)	0.4	(0.1–1.6)	0.2	0.3
Asian	0.5	0.4	(0.2–0.8)	0.008	0.5
Mean post infusion cooling time (minutes)
0–80	1.0	1.0	–	–	1.0
81–100	0.9 (NS)	0.6	(0.6–1.2)	0.3	0.9
101 +	1.0 (NS)	0.7	(0.7–1.6)	0.9	0.8
Wetting hair before scalp cooling by
Dampen hair
No	1.0	1.0	–	–	1.0
Yes	1.0 (NS)	1.2	(0.8–1.7)	0.4	1.4
Use hair conditioner
No	1.0	1.0	–	–	1.0
Yes	1.0 (NS)	1.1	(0.7–1.9)	0.6	1.0

A: doxorubicine; Carbo: carboplatin; CI: confidence interval; C: cyclophosphamide; D: docetaxel; E: epirubicine; F: 5-fluorouracil; I: irinotecan; NS: non-significant; OR: odds ratio; T: paclitaxel.

^amissings included in analysis.

^bD: mono and combination chemotherapy.

^cSignificantly associated.

Table IV. Univariate and multivariate logistic regression analysis of females with breast cancer, receiving FE50C-FE100C chemotherapy (n = 751); odds of wearing no head cover during the last scalp cooling session.

			Multivariate
FEC50 - 100	n =	Univariate OR	OR	95% CI	p-value
FEC dosage epirubicine (mgr/m^2)
50–70	38	1.0	1.0	–	–
75–85	32	0.7 (NS)	0.7	(0.3–1.9)	0.5
90	558	0.8 (NS)	0.6	(0.3–1.3)	0.2
100	122	0.3	0.3	(0.1–0.6)	0.002
Age group (years)
≤ 44	163	–	1.0	–	–
45–54	305	1.4 (NS)	1.4	(0.9–2.1)	0.2
55–64	216	1.1 (NS)	1.1	(0.7–1.8)	0.7
65 ≥	61	0.6 (NS)	0.4	(0.2–0.8)	0.01
Infusion time^a (minutes)
0–15	34	1.0	1.0	–	–
16–30	82	1.9 (NS)	2.3	(0.9–5.8)	0.08
31–45	309	2.9	2.9	(1.2–6.7)	0.01
46–60	188	3.0	3.1	(1.3–7.3)	0.01
61–90	39	4.4	5.4	(1.8–16.0)	0.002
Chemotherapy ever before	39	0.8 (NS)	0.6	(0.3–1.3)	0.2
Chemically damaged hair
Dyed	71	0.7 (NS)	0.6	(0.4–1.1)	0.09
Waved	21	0.8 (NS)	1.2	(0.4–3.3)	0.7
Coloured	279	0.9 (NS)	0.9	(0.6–1.2)	0.5
Length
< 5 cm	191	1.0	1.0	–	–
≥ 5 cm	475	0.9 (NS)	1.0	(0.7–1.4)	0.9
Quantity
Small	27	1.0	1.0	–	–
Medium	306	0.8 (NS)	0.7	(0.3–1.6)	0.3
Large	331	0.9 (NS)	0.8	(0.3–1.8)	0.5
Type of hair
West-European	627	1.0	1.0	–	–
African/Asian/South-European	37	0.5	0.5	(0.2–1.0)	0.05
Mean post infusion cooling time (minutes)
0–80	59	–	1.0	–	–
81–100	502	1.2 (NS)	1.0	(0.6–1.8)	0.9
101 +	167	1.4 (NS)	1.4	(0.8–2.7)	0.3
Wetting hair before scalp cooling by Dampen hair
No	654	1.0	1.0	–	–
Yes	96	1.0 (NS)	1.0	(0.6–1.7)	0.9
Use hair conditioner
No	700	1.0	1.0	–	–
Yes	50	1.0 (NS)	1.0	(0.5–1.9)	1.0

CI: confidence interval; C: cyclophosphamide; E: epirubicine; F: 5-fluorouracil; NS: non-significant; OR: odds ratio.

^amissings included in analysis.