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Chen X, Sun H, Yang C, Wang W, Lyu W, Zou K, Zhang F, Dai Z, He X, Dong H. Bioinformatic analysis and experimental validation of six cuproptosis-associated genes as a prognostic signature of breast cancer. PeerJ 2024; 12:e17419. [PMID: 38912044 PMCID: PMC11192027 DOI: 10.7717/peerj.17419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/28/2024] [Indexed: 06/25/2024] Open
Abstract
Background Breast carcinoma (BRCA) is a life-threatening malignancy in women and shows a poor prognosis. Cuproptosis is a novel mode of cell death but its relationship with BRCA is unclear. This study attempted to develop a cuproptosis-relevant prognostic gene signature for BRCA. Methods Cuproptosis-relevant subtypes of BRCA were obtained by consensus clustering. Differential expression analysis was implemented using the 'limma' package. Univariate Cox and multivariate Cox analyses were performed to determine a cuproptosis-relevant prognostic gene signature. The signature was constructed and validated in distinct datasets. Gene set variation analysis (GSVA) and gene set enrichment analysis (GSEA) were also conducted using the prognostic signature to uncover the underlying molecular mechanisms. ESTIMATE and CIBERSORT algorithms were applied to probe the linkage between the gene signature and tumor microenvironment (TME). Immunotherapy responsiveness was assessed using the Tumor Immune Dysfunction and Exclusion (TIDE) web tool. Real-time quantitative PCR (RT-qPCR) was performed to detect the expressions of cuproptosis-relevant prognostic genes in breast cancer cell lines. Results Thirty-eight cuproptosis-associated differentially expressed genes (DEGs) in BRCA were mined by consensus clustering and differential expression analysis. Based on univariate Cox and multivariate Cox analyses, six cuproptosis-relevant prognostic genes, namely SAA1, KRT17, VAV3, IGHG1, TFF1, and CLEC3A, were mined to establish a corresponding signature. The signature was validated using external validation sets. GSVA and GSEA showed that multiple cell cycle-linked and immune-related pathways along with biological processes were associated with the signature. The results ESTIMATE and CIBERSORT analyses revealed significantly different TMEs between the two Cusig score subgroups. Finally, RT-qPCR analysis of cell lines further confirmed the expressional trends of SAA1, KRT17, IGHG1, and CLEC3A. Conclusion Taken together, we constructed a signature for projecting the overall survival of BRCA patients and our findings authenticated the cuproptosis-relevant prognostic genes, which are expected to provide a basis for developing prognostic molecular biomarkers and an in-depth understanding of the relationship between cuproptosis and BRCA.
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Affiliation(s)
- Xiang Chen
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Hening Sun
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Changcheng Yang
- Department of The First Affiliated Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Wei Wang
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Wenzhi Lyu
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Kejian Zou
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Fan Zhang
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Zhijun Dai
- Department of The First Affiliated Hospital, Zhejiang University, Hangzhou City, Zhejiang Province, China
| | - Xionghui He
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
| | - Huaying Dong
- Department of Hainan General Hospital, Hainan Medical College, Haikou City, Hainan Province, China
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Wang W, Wang H, Luo Y, Li Z, Li J. Discovery of petroleum ether extract of eclipta targeting p53/Fas pathway for the treatment of chemotherapy-induced alopecia: Network pharmacology and experimental validation. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118405. [PMID: 38844249 DOI: 10.1016/j.jep.2024.118405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/19/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ecliptea herba, a traditional Chinese herbal medicine for hair loss, was first recorded in the Tang Dynasty's 'Qian Jin Yue Ling', of which the active ingredients and mechanisms of action in the treatment of chemotherapy-induced hair loss remain poorly investigated. AIM OF THE STUDY To investigate the effects of the petroleum ether extract of Eclipta (PEE) on alopecia and follicle damage and elucidate its potential therapeutic mechanisms using the integration of network pharmacology, bioinformatics, and experimental validation. MATERIALS AND METHODS UPLC-MS was used to analyse the chemical composition of PEE. A network pharmacology approach was employed to establish the 'components-targets-pathways' network of PEE to explore potential therapeutic pathways and targets. Molecular docking was used for validation, and the mechanism of PEE in treating chemotherapy-induced alopecia (CIA) was elucidated using in vitro and in vivo on CIA models. RESULTS UPLC-MS analysis of PEE revealed 185 components, while network pharmacology and molecular docking analyses revealed potential active compounds and their target molecules, suggesting the involvement of core genes, such as TP53, ESR1, AKT1, IL6, TNF, and EGFR. The key components included wedelolactone, dimethyl-wedelolactone, luteoloside, linarin, and hispidulin. In vivo, PEE promoted hair growth, restored the number of hair follicles, and reduced follicle apoptosis. Conversely, in vitro, PEE enhanced cell viability, reduced apoptosis, and protected HaCaT cells from damage induced by 4-hydroperoxycyclophosphamide (4-HC). CONCLUSIONS PEE alleviated hair follicle damage in CIA mice by inhibiting the P53/Fas pathway, which may be associated with inhibiting hair follicle cell apoptosis. This study provides a novel therapeutic strategy for treating cyclophosphamide-induced hair loss.
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Affiliation(s)
- Wuji Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China.
| | - Honglan Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Yang Luo
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Zheng Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Jingjie Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China.
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Tsuji T, Yoneda K, Igawa Y, Minamino E, Otani N, Yoshida Y, Kohno T. Preventive effect of free radical scavenger edaravone lotion on cyclophosphamide chemotherapy-induced alopecia. Cancer Chemother Pharmacol 2024:10.1007/s00280-024-04669-1. [PMID: 38642149 DOI: 10.1007/s00280-024-04669-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE We investigated the inhibitory effect of edaravone (EDR) lotion on chemotherapy-induced alopecia (CIA) to improve the quality of life for patients with cancer. METHODS Wistar rats were intraperitoneally injected with cyclophosphamide (CPA, 75 mg/kg) to induce CIA and divided into six groups: (1) Control; (2) EDR 0%; (3) EDR 0.3%; (4) EDR 3%. The TUNEL-positive area was examined histologically, and mRNA expression levels of the apoptosis-related factors, such as B-cell/CLL lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax), were determined. RESULTS In the three CPA-treated groups, a decrease in the coverage score (percentage of hairs covered) was observed from days 16 to 18. In addition, coverage scores on day 21, the last day of observation, showed a tendency for the suppression of hair loss to increase, though hair loss was observed in all groups. The coverage scores of the EDR 0.3% and 3% groups after day 17 were significantly higher than those of the EDR 0% group. The TUNEL-positive area of skin tissue on day 16 was extensive in the EDR 0% group and decreased in the EDR 0.3% and 3% groups. The mRNA expression ratio of Bcl-2/Bax on day 21 was maintained at the same level as that of the control group only in the EDR 3% group. CONCLUSION This study confirmed the use of EDR lotion to inhibit hair loss, indicating that the clinical application of EDR lotion may improve the quality of life for patients with cancer and their willingness to undergo treatment.
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Affiliation(s)
- Takumi Tsuji
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan.
| | - Katsuaki Yoneda
- Department of Pharmacy, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan
| | - Yu Igawa
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Erika Minamino
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Nodoka Otani
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Yuya Yoshida
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Takeyuki Kohno
- Research Institute for Production and Development, 15 Shimogamomorimoto-cho, Sakyo-ku, Kyoto-shi, Kyoto, Japan
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Mekha M, Joshi A, Maniar V, Maheshwari U, Joshi K, Kalaskar P, Sheth S, Kendre P, Morzaria D, Korgavkar R, Pethe C, Dhande S. The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study. Indian J Dermatol 2024; 69:16-23. [PMID: 38572038 PMCID: PMC10986862 DOI: 10.4103/ijd.ijd_345_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Aim Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients. Materials and Methods This is a multi-centre, retrospective-observational study including patients registered from 1st March, 2019 to 30th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy. Results A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR: 44-62 years). The prevention of alopecia (grade 0 and grade I) was seen in 81%, while more than 50% hair loss (grade 2) was seen in 16.48% after completion of treatment. The univariate analysis results showed that CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04-6.958; P = 0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295-30.787; P = 0.001). The incidence of grade 2 (>50% hair loss) alopecia was 81.3% in patients <6 weeks and was 18.8% at >6 weeks of start of chemotherapy (P < 0.0001). No adverse events were reported in 71.4% of patients, and the most common adverse event was headache (18.7%). Conclusion PSCS is an effective and well-tolerated treatment modality for preventing CIA among breast cancer patients undergoing chemotherapy.
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Affiliation(s)
- Mangesh Mekha
- From the Department of Medical Oncology, Mumbai Oncocare Centre, Pune, India
| | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Vashishth Maniar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Udip Maheshwari
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Kshitij Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pritam Kalaskar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Smit Sheth
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pradip Kendre
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Disha Morzaria
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | - Reshma Korgavkar
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | | | - Sonal Dhande
- Department of Medical Oncology, Mumbai Oncocare Centre, Nashik, India
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Landeiro LCG, Lopes Paim Miranda D, Mathias Machado R, Dienstmann R, Costa E Silva M, da Silva CF, de Castro ALR, Dos Santos APT, Bomfim VHV, Teixeira Machado B, Viviane Carvalho Rodrigues Gonçalves M, Freitas Muniz Teixeira A, Jamile Santiago Costa M, de Oliveira Dantas Viana P, Almeida P, de Cerqueira Mathias CM. Electric hand warmer versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia prevention: a randomized study. Sci Rep 2023; 13:19555. [PMID: 37945813 PMCID: PMC10636030 DOI: 10.1038/s41598-023-46840-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
Chemotherapy-induced alopecia (CIA) is a challenge in the management of cancer patients. Scalp cooling (SC) leads to reduction in CIA, however it is associated with significant adverse events, leading to 3-13% discontinuation rates. This pilot study evaluated the role of Electric Hand Warmers (EHW) on thermal (TC), sensorial (SCo) and general comfort (GC) in patients with breast cancer (BC) undergoing chemotherapy and SC to reduce CIA. Patients were randomly assigned to EHW use or observation. TC, SCo and GC were evaluated after each chemotherapy infusion. Favorable outcomes in both TC and SCo defined a positive result on GC. We analysed the impact of age, alopecia, chemotherapy regimen and EHW use in the different comfort scales using a Logistic Regression (LR) model. Forty women with early breast cancer were randomly assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years. In the EHW arm, favorable thermal response was reported by 79% versus 50% in the control arm (odds ratio [OR] 3.79, p < 0.001). SCo was satisfactory in 82% in the EHW arm versus 74% in the control arm (OR 1.62, p = 0.1). Overall, 73% in the EHW arm had favorable GC versus 44% in the control arm (OR 3.4, p < 0.001). Age, alopecia, and chemotherapy regimen did not impact on comfort measures. Conclusion: Our study suggests that the use of an EHW has a consistent favorable impact on TC and GC of BC patients under SC technology to prevent CIA.
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Affiliation(s)
| | - Diego Lopes Paim Miranda
- Complexo Hospitalar Universitário Professor Edgard Santos (C-HUPES) - Universidade Federal da Bahia (UFBA), Savador, BA, Brazil
| | | | | | | | | | | | | | | | - Bruno Teixeira Machado
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | | | | | | | | | - Pâmela Almeida
- Clínica AMO - Assistência Multidisciplinar em Oncologia, Salvador, BA, Brazil
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Almeida V, Pires D, Silva M, Teixeira M, Teixeira RJ, Louro A, Dinis MAP, Ferreira M, Teixeira A. Dermatological Side Effects of Cancer Treatment: Psychosocial Implications-A Systematic Review of the Literature. Healthcare (Basel) 2023; 11:2621. [PMID: 37830658 PMCID: PMC10572319 DOI: 10.3390/healthcare11192621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients' lives, such as quality of life (QoL), body image, cognitive fusion and social inhibition. This systematic review aimed to explore and synthesize the psychosocial impact of dermatological side effects of cancer treatment, answering the following research objectives: (i) Do the dermatological side effects of the cancer treatment present any psychosocial impact for the patients? (ii) How does the psychosocial impact of the dermatological toxicities of the cancer treatment manifest in patients' lives? Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and guided a systematic search through the PubMed, Cochrane Library and PyscNet databases. The considered studies correlate dermatological side effects of cancer treatments and their psychological/psychosocial outcomes. The studies found were all published in peer-reviewed journals. The results obtained established that cancer treatment causes the most varied skin changes, consequently reducing self-esteem and QoL; disturbing body image; and contributing to cases of stress, depression and anxiety. There is still limited literature that profoundly investigates the experience of living with these skin toxicities. The development of research lines to improve knowledge in this field will allow for significant improvements in healthcare for patients undergoing cancer treatment who need to focus more on the psychosocial implications of skin toxicities. The novelty of this review lies in adding knowledge summarizing the psychosocial implications of dermatological side effects of cancer treatment to support healthcare providers in the development of integrative therapeutic strategies for these patients in their clinical practice.
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Affiliation(s)
- Vera Almeida
- UNIPRO—Oral Pathology and Rehabilition Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal;
- UCIBIO—Applied Molecular Biosciences Unit, MedTech-Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Daniela Pires
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Marta Silva
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Maribel Teixeira
- 1H-TOXRUN—One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
| | - Ricardo João Teixeira
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - André Louro
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- RECI—Research Unit in Education and Community Intervention, Instituto Piaget—ISEIT/Viseu, 1950-157 Viseu, Portugal
| | - Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal;
- Fernando Pessoa Research, Innovation and Development Institute (FP-I3ID), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal
| | - Maria Ferreira
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Ana Teixeira
- UCIBIO—Applied Molecular Biosciences Unit, MedTech-Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
- 1H-TOXRUN—One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
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Luo R, Chen H, Liu Y, Sun H, Tang S, Chen Y. Symptom clusters among breast cancer patients in relation to chemotherapy cycles: a longitudinal study. Support Care Cancer 2023; 31:573. [PMID: 37698687 DOI: 10.1007/s00520-023-08038-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/03/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE The aim of this study was to identify symptom clusters in breast cancer patients undergoing adjuvant chemotherapy. METHODS A prospective longitudinal study was conducted. And a sample of 620 breast cancer patients receiving adjuvant chemotherapy was recruited using convenience sampling from May 20, 2020, to March 31, 2021. Data were collected eight times: the first chemotherapy cycle (T1) to the eighth cycle of chemotherapy (T8). Exploratory factor analysis was used to explore the composition of symptom clusters. RESULTS Symptoms with an incidence of less than 20% were deleted and the remaining symptoms were included in the factor analysis. Three common factors were extracted in T1, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, and menopausal symptom cluster. Five common factors were extracted from T2 to T7, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, menopausal symptom cluster, and self-image disorder symptom cluster. Four common factors were extracted at T8, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, and menopausal symptom cluster. CONCLUSION Breast cancer patients undergoing adjuvant chemotherapy experience multiple symptoms and different symptom clusters in different chemotherapy cycles. It is a benefit for health care providers to better understand and care for breast cancer patients. It will also help such women to manage concurrent symptoms ahead to promote their quality of life.
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Affiliation(s)
- Ruzhen Luo
- Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China
| | - Hongbo Chen
- School of Nursing, Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
| | - Hongyu Sun
- School of Nursing, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
| | - Siyuan Tang
- Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China.
| | - Yuhong Chen
- The First Department of Mammary Gland, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
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Michel A, Lee RT, Salehi E, Accordino MK. Improving Quality of Life During Chemotherapy: Cannabinoids, Cryotherapy, and Scalp Cooling. Am Soc Clin Oncol Educ Book 2023; 43:e390428. [PMID: 37267515 DOI: 10.1200/edbk_390428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There have been significant advances in the treatment of cancer in the past decade. However, patients continue to suffer from significant side effects of antineoplastic agents that greatly affect their quality of life (QOL), including chemotherapy-induced nausea and vomiting (CINV), chemotherapy-induced peripheral neuropathy (CIPN), and chemotherapy-induced alopecia (CIA). This review aims to provide an updated overview of emerging strategies for the management and prevention of these immediate and long-lasting side effects. The use of integrative medicine including cannabis continues to evolve in the realm of CINV and cancer-related anorexia. Although no pharmaceutical agent has been approved for the prevention of CIPN, cryotherapy, compression therapy and, more recently, cryocompression therapy have shown benefit in small trials, but there are concerns with tolerability especially related to cryotherapy. More data are necessary to determine an effective and tolerable option to prevent CIPN in large, randomized studies. Scalp cooling (SC), which has a similar mechanism to cryotherapy and compression therapy for CIPN prevention, has proven to be an effective and tolerable approach in randomized studies and has significantly limited CIA, an entity that definitively affects the QOL of patients living with cancer. Taken together, cannabis, cryotherapy, compression and cryocompression therapy, and SC all strive to improve the QOL of patients living with cancer by minimizing the side effects of chemotherapeutic agents.
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Affiliation(s)
- Alissa Michel
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | | | | | - Melissa K Accordino
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
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Lodewijckx J, Robijns J, Claes M, Pierson M, Lenaerts M, Mebis J. The use of photobiomodulation therapy for the management of chemotherapy-induced alopecia: a randomized, controlled trial (HAIRLASER trial). Support Care Cancer 2023; 31:269. [PMID: 37060420 DOI: 10.1007/s00520-023-07743-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/08/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The purpose of this trial was to evaluate if photobiomodulation (PBM) can accelerate hair regrowth after chemotherapy in breast cancer patients and if this is correlated with a better quality of life (QoL). METHODS A randomized controlled trial with breast cancer patients that underwent an anthracycline and taxane-containing chemotherapy regimen was set up at the Jessa Hospital (Hasselt, Belgium). Patients were randomized into the control group (no intervention) or the PBM group (three PBM sessions each week for 12 weeks, starting the last day of their chemotherapy). Hair regrowth was evaluated based on photographic assessments. Two blinded researchers independently scored the hair regrowth using a numerical rating scale (NRS). In addition, the QoL was measured using the European Organization for Research and Treatment-QOL questionnaire and Breast Cancer-specific module (EORTC QLQ-C30 and QLQ-BR23). Data were collected on the day of their last chemotherapy session and 1, 2, and 3 months post-chemotherapy. RESULTS A total of 32 breast cancer patients were included in the trial between June 2020 and February 2022. Significantly higher NRS scores were observed in the PBM group at 1-month post-chemotherapy compared to baseline, whereas they remained constant in the control group. Patients allocated to the PBM group scored their global health significantly higher at all time points compared to the control. CONCLUSION Based on the results of the HAIRLASER trial, PBM seems to accelerate hair regrowth after chemotherapy in breast cancer patients resulting in an improved global health status and better body image. The study was registered in July 2019 at ClinicalTrials.gov (NCT04036994).
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Affiliation(s)
- Joy Lodewijckx
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
| | - Jolien Robijns
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Marithé Claes
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Maud Pierson
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Melissa Lenaerts
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Jeroen Mebis
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
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10
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Kocan S, Aktug C, Gursoy A. "Who am I?" A qualitative meta-synthesis of Chemotherapy-induced alopecia and body image perception in breast cancer patients. Support Care Cancer 2023; 31:237. [PMID: 36973593 DOI: 10.1007/s00520-023-07704-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Since alopecia may be the first physical evidence and sign of cancer diagnosis and treatment, it may have a more serious and challenging effect on a woman than the loss of breast tissue. OBJECTIVE The purpose of this study was to summarize the current qualitative research which explores the body image perceptions of breast cancer patients with chemotherapy-induced alopecia. MATERIAL AND METHODS We searched three electronic databases and reviewed studies from December 2011 to December 2021 for qualitative results analysing the experiences of women with breast cancer and chemotherapy-induced alopecia. The Joanna Briggs Institute critical (JBI) appraisal tool was used to assess the quality of the targeted studies. The Meta-synthesis process developed by Sandelowski and Barroso was used to collect and analyse the data. RESULTS We discovered two main and five sub-themes from the meta-synthesis findings of 11 qualitative studies involving 225 women. The main themes were "I am not comfortable in this body" and "Who am I?". The first main theme revealed patients' intense reactions to their hair loss: "I'm in emotional chaos", "I am looking for a place to hide" and "I knew it and now I'm experiencing it".The second main theme of "Who am I?" contained two sub-themes: "What did my hair take from my femininity when it was gone?" and "Will I lose my partner after my hair?". CONCLUSION Meta-synthesis provided an up-to-date and integrated interpretation of scientific results about the experiences of women with breast cancer, alopecia, and their body image perceptions. This interpretation will facilitate a more comprehensive understanding of the alopecia-body image relationship. Thus, the aim of the meta-synthesis results is that these will contribute to nurses' understanding of how alopecia, although a temporary symptom, affects women's perceptions of body image.
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Affiliation(s)
- Sema Kocan
- Faculty of Health Sciences, Recep Tayyip Erdogan University, Rize, Turkey.
| | - Cemile Aktug
- Faculty of Health Sciences, Gümüshane University, Gümüshane, Turkey
| | - Ayla Gursoy
- Faculty of Health Sciences, Antalya Bılım University, Antalya, Turkey
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11
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Aiba T, Kono Y, Etoh T, Kawano Y, Oshima Y, Inomata M. Efficacy of cooling therapy and α-lipoic acid derivative against chemotherapy-induced alopecia in an animal model. Cancer Sci 2023; 114:1007-1014. [PMID: 36337052 PMCID: PMC9986063 DOI: 10.1111/cas.15639] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
Chemotherapy-induced alopecia is frequently induced by various regimens of chemotherapy and has a significant impact on mental health and quality of life. However, the effect of available current treatment for chemotherapy-induced alopecia is not sufficient. This study aimed to clarify the therapeutic effects and mechanism of skin cooling and the antioxidant α-lipoic acid derivative on chemotherapy-induced alopecia. We developed a chemotherapy-induced alopecia model of cyclophosphamide (120 μg/g) using Institute of Cancer Research mice. We used cooling therapy and α-lipoic acid derivative application as the treatments. We compared the alopecia score, hair bulb diameter, insulin-like growth factor-1 level, vascular permeability, and apoptosis between the control and treatment groups. The alopecia score significantly improved in each treatment group compared with that in the cyclophosphamide group. Hair bulb diameter significantly improved in the cyclophosphamide + cooling group compared with that in the cyclophosphamide group. The insulin-like growth factor-1 level and vascular permeability level was significantly retained and suppressed, respectively, in each treatment group compared with that in the cyclophosphamide group. The number of apoptotic cells in the vascular endothelium significantly decreased in the cyclophosphamide + α-lipoic acid derivative group compared with that in the cyclophosphamide group. In conclusion, cooling therapy and α-lipoic acid derivative facilitated recovery from chemotherapy-induced alopecia caused by cyclophosphamide through decreasing vascular permeability.
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Affiliation(s)
- Takayuki Aiba
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yohei Kono
- Department of Advanced Medical Research and Development for Cancer and Hair [Aderans], Oita University Faculty of Medicine, Yufu, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yoko Kawano
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yusuke Oshima
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.,Faculty of Engineering, University of Toyama, Toyama, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.,Department of Advanced Medical Research and Development for Cancer and Hair [Aderans], Oita University Faculty of Medicine, Yufu, Japan
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12
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Thornton M, Lewis-Smith H. " I listen to my body now": a qualitative exploration of positive body image in breast cancer survivors . Psychol Health 2023; 38:249-268. [PMID: 34323620 DOI: 10.1080/08870446.2021.1956494] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Existing research has identified the high prevalence of body image concerns among female breast cancer survivors. However, it has neglected to explore the experience of positive body image among this group, despite its potential utility for intervention development. The present study therefore aimed to explore the experiences of breast cancer survivors who self-identified as experiencing a positive relationship with their post-treatment bodies. DESIGN Twenty-two participants (M age = 54, SD = 8.38) were interviewed using a semi-structured approach. RESULTS Thematic analysis identified three overarching themes amongst the qualitative data: (1) Resisting appearance pressures, (2) Receiving care, and (3) Self-worth beyond appearance. Findings indicated that women's life experiences had led them to develop a critical awareness of the unrealistic nature of appearance ideals. Their experience of positive body image was also attributed to engaging in self-care and receiving supportive care from others. Finally, women expressed prioritising functionality and health over their physical appearance. CONCLUSION The present findings advance the theoretical understanding of positive body image in a breast cancer population. They also provide an opportunity to test theorised models of positive body image.
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Affiliation(s)
- Maia Thornton
- Centre for Appearance Research, Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Helena Lewis-Smith
- Centre for Appearance Research, Health and Applied Sciences, University of the West of England, Bristol, UK
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13
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Rose L, Schnell PM, Radcliff L, Lustberg M, Dulmage B. Retrospective cohort study of scalp cooling in breast cancer patients. Support Care Cancer 2023; 31:118. [PMID: 36645520 DOI: 10.1007/s00520-022-07562-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/21/2022] [Indexed: 01/17/2023]
Abstract
For patients with cancer, alopecia is a common side effect that negatively impacts personal identity, body image, self-esteem, quality of life, and medical decision-making. Scalp cooling is a technique used to prevent alopecia in patients undergoing chemotherapy in which patients wear a cooled cap during chemotherapy infusions, causing localized vasoconstriction of blood vessels on the scalp. Because of the recent emergence of scalp cooling, there is a need to explore further the reasons why patients pursue this treatment. A retrospective chart review of women with breast cancer treated at The Ohio State University was conducted to investigate how factors such as patient age, race, ethnicity, insurance status, stage of cancer, and chemotherapy regimen influenced patients' decisions to incorporate scalp cooling into their treatment plan as compared to those who did not. Findings revealed that patient age, race, insurance status, and chemotherapy regimen were predictors of a patient's likelihood to undergo scalp cooling. Patients diagnosed at younger age and those with private insurance were more likely to utilize scalp cooling. In comparison to White patients, non-White patients were less likely to choose scalp cooling. Furthermore, patients placed on the chemotherapy regimen of AC or AC-T were less likely to pursue scalp cooling than patients on PTCH or TC regimens. These findings provide background for the development of educational resources for both patients interested in this therapy and healthcare providers discussing this treatment option in dermatology and oncology settings.
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Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Lindsey Radcliff
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maryam Lustberg
- Breast Cancer Center, Smilow Cancer Hospital, Yale University, New Haven, CT, USA
| | - Brittany Dulmage
- The Ohio State University Wexner Medical Center, Columbus, OH, USA. .,Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, OH, 43230, Gahanna, USA.
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14
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Freites-Martinez A, Navitski A, Friedman CF, Chan D, Goldfarb S, Lacouture ME, O'Cearbhaill RE. Shared decision making for patients with breast and gynecologic malignancies undergoing chemotherapy associated with persistent alopecia. Gynecol Oncol Rep 2022; 44:101095. [PMID: 36388759 PMCID: PMC9640350 DOI: 10.1016/j.gore.2022.101095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To assess patient-perceived involvement in shared decision making among those diagnosed with breast or gynecologic malignancies undergoing chemotherapy associated with persistent chemotherapy-induced alopecia (pCIA). We also sought to identify factors that influence shared decision making. Methods We recruited patients from the Gynecologic Medical Oncology and Breast Medicine Services at a large academic center for this prospective cohort study. All patients were scheduled to start chemotherapy between June 1, 2017 and December 31, 2017. Following medical consultation, including discussion of the risk of pCIA, patients completed the 9-item Shared Decision Making Questionnaire (SDM-Q-9). Clinical and sociodemographic information was also collected. Univariate analysis was used to evaluate SDM-Q-9 total scores and their constituents for all variables. Results Sixty-one patients completed the survey. The median total SDM-Q-9 score was 95.6 (95% CI: 90-100). Most patients (n = 57, 93%) reported a high level of involvement (SDM-Q-9 total score > 66). There was no difference in total scores between patients with breast compared with gynecologic cancer (P > .05). By individual item, the scores for item Q1 ("My doctor made clear that a decision needs to be made") were significantly lower for Black patients and those with advanced disease (P < .05). Conclusions Most patients indicated they were adequately involved in shared decision making regarding chemotherapy treatment options and their risk for pCIA. Patients from underrepresented populations and those with advanced disease may benefit from additional support from their clinicians to better address the anticipated psychosocial impacts of pCIA and facilitate the provision of optimal and equitable care.
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Affiliation(s)
- Azael Freites-Martinez
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anastasia Navitski
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, United States
| | - Claire F. Friedman
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan, Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Donald Chan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Shari Goldfarb
- Department of Medicine, Weill Cornell Medical College, New York, NY, United States,Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer, Center, New York, NY, United States
| | - Mario E. Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Roisin E. O'Cearbhaill
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan, Kettering Cancer Center, New York, NY, United States,Department of Medicine, Weill Cornell Medical College, New York, NY, United States,Corresponding author at: Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
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15
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Mitigating acute chemotherapy-associated adverse events in patients with cancer. Nat Rev Clin Oncol 2022; 19:681-697. [PMID: 36221000 DOI: 10.1038/s41571-022-00685-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/08/2022]
Abstract
Despite the enthusiasm surrounding novel targeted agents and immunotherapies, chemotherapy remains the mainstay treatment for most human malignancies, either alone or in combination. Yet, the burden of chemotherapy-associated adverse events (CAAEs) remains high and, importantly, is associated with considerable morbidity, mortality and costs that affect patients across multiple dimensions, including physical, emotional and social functioning. CAAEs can directly affect patient outcomes and indirectly increase the risk of cancer recurrence by compromising treatment intensity and continuity. Systematic efforts to identify and critically summarize the evidence on management approaches for CAAEs remain limited. Herein, we review the most common acute CAAEs having a major effect on survival, quality of life, function and/or continuation of optimal therapy. We focus on selected acute toxicities that occur during treatment, summarizing their underlying pathophysiology, multifactorial aetiologies, evidenced-based treatments, prevention strategies and management recommendations. We also summarize the available evidence on risk factors, validated risk assessment tools and other efforts to optimize symptom control in patients most likely to benefit in order to personalize the prevention and treatment of acute CAAEs. Finally, we discuss innovative symptom monitoring and supportive care interventions that are under development to further improve the outcomes of patients with cancer.
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16
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Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, Bossi P, Chilles A, Corby PM, Epstein JB, Elad S, Fekrazad R, Fregnani ER, Genot MT, Ibarra AMC, Hamblin MR, Heiskanen V, Hu K, Klastersky J, Lalla R, Latifian S, Maiya A, Mebis J, Migliorati CA, Milstein DMJ, Murphy B, Raber-Durlacher JE, Roseboom HJ, Sonis S, Treister N, Zadik Y, Bensadoun RJ. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol 2022; 12:927685. [PMID: 36110957 PMCID: PMC9468822 DOI: 10.3389/fonc.2022.927685] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
DisclaimerThis article is based on recommendations from the 12th WALT Congress, Nice, October 3-6, 2018, and a follow-up review of the existing data and the clinical observations of an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This article is informational in nature. As with all clinical materials, this paper should be used with a clear understanding that continued research and practice could result in new insights and recommendations. The review reflects the collective opinion and, as such, does not necessarily represent the opinion of any individual author. In no event shall the authors be liable for any decision made or action taken in reliance on the proposed protocols.ObjectiveThis position paper reviews the potential prophylactic and therapeutic effects of photobiomodulation (PBM) on side effects of cancer therapy, including chemotherapy (CT), radiation therapy (RT), and hematopoietic stem cell transplantation (HSCT).BackgroundThere is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis (OM) in patients undergoing RT for head and neck cancer (HNC), CT, or HSCT. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care.MethodsA literature review on PBM effectiveness and dosimetry considerations for managing certain complications of cancer therapy were conducted. A systematic review was conducted when numerous randomized controlled trials were available. Results were presented and discussed at an international consensus meeting at the World Association of photobiomoduLation Therapy (WALT) meeting in 2018 that included world expert oncologists, radiation oncologists, oral oncologists, and oral medicine professionals, physicists, engineers, and oncology researchers. The potential mechanism of action of PBM and evidence of PBM efficacy through reported outcomes for individual indications were assessed.ResultsThere is a large body of evidence demonstrating the efficacy of PBM for preventing OM in certain cancer patient populations, as recently outlined by the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Building on these, the WALT group outlines evidence and prescribed PBM treatment parameters for prophylactic and therapeutic use in supportive care for radiodermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, alopecia, oral and dermatologic chronic graft-versus-host disease, voice/speech alterations, peripheral neuropathy, and late fibrosis amongst cancer survivors.ConclusionsThere is robust evidence for using PBM to prevent and treat a broad range of complications in cancer care. Specific clinical practice guidelines or evidence-based expert consensus recommendations are provided. These recommendations are aimed at improving the clinical utilization of PBM therapy in supportive cancer care and promoting research in this field. It is anticipated these guidelines will be revised periodically.
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Affiliation(s)
- Jolien Robijns
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Raj G. Nair
- Oral Medicine, Oral Pathology and Oral Oncology, Griffith University, Department of Haematology and Oncology, Gold Coast University Hospital, Gold Coast, QL, Australia
| | - Joy Lodewijckx
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Praveen Arany
- School of Dental Medicine, Oral Biology and Biomedical Engineering, University at Buffalo, Buffalo, NY, United States
| | - Andrei Barasch
- Harvard School of Dental Medicine, Division of Oral Medicine and Dentistry, Boston, MA, United States
| | - Jan M. Bjordal
- Physiotherapy Research Group, IGS, University of Bergen, Bergen, Norway
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Anne Chilles
- Radiotherapy Department, Institut Curie, Paris, France
| | - Patricia M. Corby
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, United States
| | - Joel B. Epstein
- City of Hope Duarte, CA and Cedars-Sinai Health System, Los Angeles, CA, United States
| | - Sharon Elad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty – Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | | | - Marie-Thérèse Genot
- Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium
| | - Ana M. C. Ibarra
- Postgraduate Program on Biophotonics Applied to Health Sciences, Nove de Julho University, São Paulo, Brazil
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Vladimir Heiskanen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Ken Hu
- Department of Radiation Oncology, NYU Langone Health, New York, NY, United States
| | | | - Rajesh Lalla
- Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, United States
| | - Sofia Latifian
- Department of Medicine, Institut Jules Bordet, Universiteí Libre de Bruxelles, Brussels, Belgium
| | - Arun Maiya
- Manipal College of Health Professions, MAHE, Manipal, India
| | - Jeroen Mebis
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Cesar A. Migliorati
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, Florida, United States
| | - Dan M. J. Milstein
- Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Barbara Murphy
- Department of Oncology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Judith E. Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hendrik J. Roseboom
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine; Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine; Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Yehuda Zadik
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, and Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - René-Jean Bensadoun
- Department of Radiation Oncology, Centre de Haute Energie, Nice, France
- *Correspondence: René-Jean Bensadoun,
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Amarillo D, De Boni D, Cuello M. [Translated article] Chemotherapy, Alopecia, and Scalp Cooling Systems. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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18
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Amarillo D, de Boni D, Cuello M. Alopecia, quimioterapia y gorras de frío o «scalp cooling system». ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:278-283. [DOI: 10.1016/j.ad.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/12/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022] Open
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PINK1/Parkin-mediated mitophagy inhibits warangalone-induced mitochondrial apoptosis in breast cancer cells. Aging (Albany NY) 2021; 13:12955-12972. [PMID: 33929971 PMCID: PMC8148507 DOI: 10.18632/aging.202965] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022]
Abstract
Breast cancer is the most common malignancy in women all around the world, especially in many countries in Asia. However, antitumor drugs with unique curative effects and low toxic side-effects have not been found yet. Warangalone is an isoflavone extracted from the Cudrania tricuspidata fruit, and is reported to possess anti-inflammatory and anti-cancer activity. The purpose of this study was to determine the effects of warangalone on breast cancer cells. In this study, we found that warangalone decreased the viability of breast cancer cells by increasing the generation of reactive oxygen species (ROS) resulting in mitochondrial damage and decreased mitochondrial membrane potential (MMP). Warangalone induced mitochondrial apoptosis by increasing the BAX/BCL-2 ratio. Warangalone activated mitophagy via upregulation of PINK1 and Parkin expression and co-localization. The combination of warangalone and autophagy inhibitors or PINK1 siRNA increased the degree of cell apoptosis compared to treatment with warangalone alone. Warangalone damages mitochondria via ROS, thereby triggering PINK1/Parkin-mediated mitophagy and inducing mitochondrial apoptosis. However, autophagy/mitophagy protects against warangalone-induced mitochondrial apoptosis. A combination of warangalone and autophagy/mitophagy inhibitors may be a potential treatment for breast cancer.
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20
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Wang S, Yang T, Shen A, Qiang W, Zhao Z, Zhang F. The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer 2021; 29:6943-6956. [PMID: 33847828 DOI: 10.1007/s00520-021-06188-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/28/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically assess the efficacy and side effects of scalp cooling in patients with breast cancer. METHODS A systematic literature search was conducted in October 2020 across Cochrane Library, PubMed, Embase, CINAHL, Web of Science, Scopus, and four Chinese databases (CNKI, Wanfang, SinoMed, and VIP database). Our review included all randomized controlled trials, cohort studies, and cross-sectional studies. Two authors independently searched databases, screened studies, extracted data, and evaluated each included study's methodological quality and risk bias. Meta-analysis was performed using Stata 15.1 software package and Revman 5.3 software, with estimates of scalp cooling effect and its side effects from pooled using a random-effects model. This study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020216224). RESULTS In total, 755 articles were screened and data from 27 studies involving 2202 participants were used in the meta-analysis. Studies meeting inclusion and exclusion criteria were three randomized clinical trials, 12 cohort studies, and 12 cross-sectional studies. The effectiveness rate of using a scalp cooling device to protect hair was 61% (95% CI: 55 to 67%, I2 = 88%, P = 0.000). However, scalp cooling therapy's side effects are not be ignored, such as headache, dizziness, scalp pain, neck pain, feeling cold, heaviness of the head, skin rash, nausea, and overtightened strap. CONCLUSIONS This review shows that scalp cooling devices can significantly improve the patients with breast cancer chemotherapy-induced alopecia, but the implications of its side effects provide guide for the implementation of this technology.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Aomei Shen
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
| | - Zihan Zhao
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fangyuan Zhang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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21
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Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients. Support Care Cancer 2021; 29:6119-6125. [PMID: 33797582 PMCID: PMC8410694 DOI: 10.1007/s00520-021-06168-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 03/18/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. PATIENTS AND METHODS One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients' answers to the questionnaire regarding the use of a wig or hat (subjective grades). RESULTS Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. CONCLUSIONS Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.
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Yoneda K, Fujii M, Imaoka A, Kobayashi R, Hayashi R, Yoshida Y, Kohno T, Tsuji T. Preventive effect of edaravone ointment on cyclophosphamide-chemotherapy induced alopecia. Support Care Cancer 2021; 29:6127-6134. [PMID: 33797584 DOI: 10.1007/s00520-021-06189-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We evaluated the preventive effect of the antioxidant edaravone (EDR) on chemotherapy-induced alopecia (CIA) to improve quality of life in cancer patients. METHODS Hair loss was induced by intraperitoneally administering cyclophosphamide (CPA, 75 mg/kg) to rats, and topically applying EDR ointment (100 mg/day) once daily for 16 days (when hair loss starts) or 21 days (just before hair growth). The rats were divided into four groups: control group (without CPA or EDR), EDR 0% group (CPA + EDR 0%), EDR 3% group (CPA + EDR 3%), and EDR 30% group (CPA + EDR 30%). The prevention of CIA was evaluated by the hair coverage score (five levels from 0 to 4). Furthermore, we measured the size of the hair follicle area and the expression levels of insulin-like growth factor (IGF)-1 mRNA in dermal papilla cells. RESULTS The EDR 3% and EDR 30% groups exhibited higher hair coverage scores than the EDR 0% group on day 16 and day 21. On day 16, the hair follicle area in the EDR 3% and EDR 30% groups was significantly larger than that in the EDR 0% group. Furthermore, IGF-1 expression levels in the EDR 3% group were significantly higher than those in the EDR 0% group. On day 21, no significant difference was observed in hair follicle area or IGF-1 mRNA levels among the groups. CONCLUSION Our results show that EDR administration lessened hair loss due to CPA in a dose-independent manner above doses of 3%, suggesting potential applications beside chemotherapy.
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Affiliation(s)
- Katsuaki Yoneda
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan.,Department of Pharmacy, Kouseikai Takai Hospital, 470-8 Kuranosho-cho, Tenri, Nara, 632-0006, Japan
| | - Miyu Fujii
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Aoi Imaoka
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Remi Kobayashi
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Ryoya Hayashi
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Yuya Yoshida
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Takeyuki Kohno
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan
| | - Takumi Tsuji
- Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, 573-0101, Japan.
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Can tele-nursing affect the supportive care needs of patients with cancer undergoing chemotherapy? A randomized controlled trial follow-up study. Support Care Cancer 2021; 29:5865-5872. [PMID: 33758968 PMCID: PMC7987327 DOI: 10.1007/s00520-021-06056-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/07/2021] [Indexed: 11/29/2022]
Abstract
Purpose In some countries, telephone-based support is one of the key services used for supporting patients with cancer. However, there is a lack of research on the efficacy of this method in Iran. This study aimed to evaluate the effects of tele-nursing on supportive care needs (SCNs) of patients with cancer undergoing chemotherapy. Methods This randomized controlled trial was conducted on 60 patients with cancer undergoing chemotherapy who were randomly assigned and allocated to two groups, an intervention group and a control group. Patients’ SCNs were assessed in the baseline, and 1 and 2 months after commencement of the intervention using the SCNs Survey -Short Form 34. The data were analyzed through descriptive statistics, t-test, and repeated measure test, by SPSS version 16. Results There were no significant statistical differences in the mean score of dimensions and total SCNs between the two groups in baseline (p˃0.05). However, the results showed that the mean score of dimensions and total SCNs in the intervention group were significantly less than the control group, after the intervention (p˂0.05). Conclusions Telephone-based support is an effective method to address and reduce SCNs of patients with cancer undergoing chemotherapy through increasing access to support for this population especially who may be in rural and remote settings. During the COVID_19 pandemic and given the vulnerability of patients with cancer, telephone support can be used to avoid unnecessary visits to hospitals and reduced the risk of transmitting the virus to the patients. Trial registration number IRCT20170404033216N1
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24
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Chan J, Adderley H, Alameddine M, Armstrong A, Arundell D, Fox R, Harries M, Lim J, Salih Z, Tetlow C, Wong H, Thorp N. Permanent hair loss associated with taxane chemotherapy use in breast cancer: A retrospective survey at two tertiary UK cancer centres. Eur J Cancer Care (Engl) 2020; 30:e13395. [PMID: 33350015 DOI: 10.1111/ecc.13395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 09/08/2020] [Accepted: 11/27/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Taxane chemotherapy is commonly used in the management of breast cancer. Hair loss (alopecia) is an expected side effect which may have a significant effect on quality of life. Alopecia is normally temporary but permanent chemotherapy-induced alopecia (pCIA) is increasingly recognised especially following docetaxel chemotherapy. However, the prevalence following docetaxel is not well understood and there is no published literature for paclitaxel chemotherapy. The aim of this study is to investigate the prevalence and patterns of pCIA resulting from both docetaxel and paclitaxel chemotherapy at two tertiary UK cancer centres. METHODS In collaboration between Clatterbridge Cancer Centre and The Christie NHS Foundation Trusts, a retrospective survey was conducted for breast cancer patients who had received taxane chemotherapy in the neoadjuvant and adjuvant settings. Patients who had concluded chemotherapy at least a year previously were contacted by post and invited to participate by completing a questionnaire and returning it to their treatment centre. Data collected included the incidence and pattern of pCIA using the Savin pictorial hair loss scale, and the methods used by patients to manage it. Fisher's exact test was used to compare pCIA between the docetaxel and paclitaxel cohorts. RESULTS 383 patients responded to the survey (a 63.3% overall response rate). These comprised 245 patients receiving docetaxel and 138 patients treated with paclitaxel. pCIA was reported by 23.3% of patients receiving docetaxel and 10.1% paclitaxel (p < 0.01). Overall 16.7% of patients in both groups reported the ongoing use of products or appliances such as wigs to camouflage their pCIA. In the docetaxel group, pCIA appeared to be more frequent in post-menopausal women than peri- or pre-menopausal women (37.8%, 12.3% and 19.6% respectively [Chi-square test p < 0.01]). Also in the docetaxel group, there appeared to be a trend for more severe scalp alopecia when the patient also received an aromatase inhibitor (AI) or tamoxifen and this difference was most marked in those who had received both an AI and tamoxifen as components of their treatment regime (p = 0.04). The use of scalp cooling was only recorded in the Christie paclitaxel group (n = 12). Of these 12 patients, 83.3% reported no hair loss. While overall rates of permanent eyebrow, eyelash and nostril hair loss were low, this pattern of hair loss appeared more frequent in the paclitaxel than the docetaxel group 4.3% vs. 1.8% (p = 0.29). CONCLUSIONS Both docetaxel and paclitaxel may cause permanent scalp hair loss, but it is significantly more prevalent with docetaxel compared with paclitaxel. IMPLICATIONS FOR CANCER SURVIVORS Clinicians should counsel patients regarding the risk of permanent alopecia prior to embarking upon taxane chemotherapy and routinely offer scalp cooling if available. More research is required to understand the pathobiology of this important and previously under recognised long-term side effect to enable more active preventive and management approaches.
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Affiliation(s)
- Joachim Chan
- Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK
| | | | - Manal Alameddine
- Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK
| | | | - Donna Arundell
- Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK
| | - Rosalyn Fox
- The Christie NHS Foundation Trust, Manchester, UK
| | - Matthew Harries
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jonathan Lim
- The Christie NHS Foundation Trust, Manchester, UK
| | - Zena Salih
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - Helen Wong
- Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK
| | - Nicola Thorp
- Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, UK.,The Christie NHS Foundation Trust, Manchester, UK
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Kapoor R, Shome D, Doshi K, Vadera S, Patel G, Kumar V. Evaluation of efficacy of QR678 ® and QR678 ® Neo hair growth factor formulation in the treatment of persistent chemotherapy-induced alopecia caused due to cytotoxic chemotherapy-A prospective pilot study. J Cosmet Dermatol 2020; 19:3270-3279. [PMID: 33016514 DOI: 10.1111/jocd.13759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cancers are one of the main reasons of morbidity and mortality globally. Chemotherapy-induced alopecia (CIA) is one of the most alarming, terrifying, and traumatic adverse effects. A range of therapeutic measures has been suggested to alleviate CIA, but at present, there is no accepted pharmacological therapy that can assure prevention or management. AIM The aim of the present study was to evaluate the efficacy of QR 678 Neo® therapy in the treatment of persistent chemotherapy-induced alopecia in women and men treated with cytotoxic chemotherapy for breast and lung cancers, respectively. METHODS A total of 8 male patients with history of lung cancer and 12 female patients with history of breast cancer in the age range of 25-60 years, with WHO classification of grade I and II persistent alopecia who had undergone chemotherapy treatment, were selected for the study. At each visit, 1.5 mL solution of QR 678® was injected into the scalp skin of patients. A total of 8 sessions were performed at an interval of 3 weeks each. All the patients were evaluated with standard global photography, video microscopic assessment, and patient self-assessment questionnaire at baseline, 6 months, and 1 year. RESULTS Marked improvement was seen in the global assessment score at 6 months (mean-8) which was maintained even after 1 year. Mean score increase in hair count at 6 months was 12.71 which further increased at 1 year. High satisfaction score was given by patients for slowing of hair loss (mean = 4.2) and also for overall hair growth. For appearance and growth of hair, the mean value was 3.4 and 3.8, respectively. CONCLUSION The formulation of QR 678® and QR 678® Neo showed to be significantly safe and efficient for chemotherapy-induced alopecia in both men and women. Improvement in hair growth was maintained even at 1 year of follow-up. No patient had any severe adverse effects, and injections were also easily bearable by most of them.
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Affiliation(s)
- Rinky Kapoor
- Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery & Director, The Esthetic Clinics, Mumbai, India
| | - Debraj Shome
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery & Director, The Esthetic Clinics, Mumbai, India
| | - Komal Doshi
- Fellow in Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | - Sapna Vadera
- Fellow in Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | | | - Vaibhav Kumar
- Clinical Research Coordinator, The Esthetic Clinics, Terna Dental College, Mumbai, India
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26
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毛 联, 刘 会, 刘 华, 卞 中, 张 秋, 廖 文, 孙 素. [Preparation of warangalone-loaded liposomes and its inhibitory effect on breast cancer cells]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:876-883. [PMID: 32895205 PMCID: PMC7321263 DOI: 10.12122/j.issn.1673-4254.2020.06.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To prepare warangalone-loaded thermosensitive liposomes (WLTSL) and evaluate its inhibitory effect on breast cancer cells in vitro. METHODS MTT assay was used to assess the changes in proliferation of 3 breast cancer cell lines (MDA-MB-231, MCF7, and SKBR3) following treatment with warangalone, soy isoflavone and genistein. Colony-forming assay and wound healing assay was used to assess colony forming activity and migration of MDA-MB-231 cells treated with warangalone. The effect of warangalone on the expression of MMP2 and MMP9 in MDA-MB-231 cells was examined with Western blotting. The thermosensitive liposomes (TSL) and WLTSL were prepared using a thin film hydration method, and the morphology, size, encapsulation efficiency and stability of the prepared liposomes were characterized using transmission electron microscopy, dynamic light scattering scanning and UV spectrophotometry. MTT assay was used to examine the inhibitory effect of WLTSL on mouse breast cancer cells (4T1) in vitro. RESULTS Warangalone showed stronger anti-proliferation effects than soy isoflavones and genistein in the 3 human breast cancer cell lines and significantly inhibited colony formation by MDA-MB-231 cells. Treatment with warangalone significantly inhibited migration of the breast cancer cells and down-regulated the cellular expressions of MMP2 and MMP9. The prepared TSL and WLTSL presented with a homogeneous, irregular spherical morphology, with a mean particle size of 56.23±0.61 nm, a polymer dispersity index of 0.241±0.014, a Zeta potential of -40.40±0.46 mV, and an encapsulation efficiency was 87.68±2.41%. WLTSL showed a good stability at 4 ℃ and 37 ℃ and a stronger inhibitory effect than warangalone in 4T1 cells. CONCLUSIONS Warangalone inhibits the proliferation, migration and invasion of breast cancer cells, and the prepared WLTSL possesses good physical properties and strong anti-breast cancer activity.
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Affiliation(s)
- 联智 毛
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 会平 刘
- 时代生物(深圳)科技有限公司,广东 深圳 518000ERA (Shenzhen) Biotechonology, Shenzhen 518000, China
| | - 华缓 刘
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 中博 卞
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 秋玉 张
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 文镇 廖
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - 素霞 孙
- 南方医科大学公共卫生学院营养与食品卫生学系,广东 广州 510515Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
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27
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A systematic review of tumor treating fields therapy for high-grade gliomas. J Neurooncol 2020; 148:433-443. [DOI: 10.1007/s11060-020-03563-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/15/2020] [Indexed: 01/18/2023]
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28
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Stamatiou CA, Lens A, Perez CI, Daunert S, Jimenez JJ. The Role of Platelet-Rich Plasma in the Prevention of Chemotherapy-Induced Alopecia. Skin Appendage Disord 2020; 6:58-60. [PMID: 32021866 PMCID: PMC6995967 DOI: 10.1159/000503836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/30/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Christina A. Stamatiou
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Assuan Lens
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Carmen I. Perez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. JT Macdonald Foundation Biomedical Nanotechnology Institute of the University of Miami, Miami, Florida, USA
- University of Miami Clinical and Translational Science Institute, Miami, Florida, USA
| | - Joaquin J. Jimenez
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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29
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Upadhyaya P, Di Serafino A, Sorino L, Ballerini P, Marchisio M, Pierdomenico L, Stuppia L, Antonucci I. Genetic and epigenetic modifications induced by chemotherapeutic drugs: human amniotic fluid stem cells as an in-vitro model. BMC Med Genomics 2019; 12:146. [PMID: 31660974 PMCID: PMC6816179 DOI: 10.1186/s12920-019-0595-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Bleomycin, etoposide and cisplatin (BEP) are three chemotherapeutic agents widely used individually or in combination with each other or other chemotherapeutic agents in the treatment of various cancers. These chemotherapeutic agents are cytotoxic; hence, along with killing cancerous cells, they also damage stem cell pools in the body, which causes various negative effects on patients. The epigenetic changes due to the individual action of BEP on stem cells are largely unknown. METHODS Human amniotic fluid stem cells (hAFSCs) were treated with our in-vitro standardized dosages of BEP individually, for seven days. The cells were harvested after the treatment and extraction of DNA and RNA were performed. Real-time PCR and flow cytometry were conducted for cell markers analysis. The global DNA methylation was quantified using 5mC specific kit and promoter and CpG methylation % through bisulfite conversion and pyrosequencing. Micro- RNAs (miRNAs) were quantified with real-time qPCR. RESULTS The cytotoxic nature of BEP was observed even at low dosages throughout the experiment. We also investigated the change in the expression of various pluripotent and germline markers and found a significant change in the properties of the cells after the treatments. The methylation of DNA at global, promoter and individual CpG levels largely get fluctuated due to the BEP treatment. Several tested miRNAs showed differential expression. No positive correlation between mRNA and protein expression was observed for some markers. CONCLUSION Cytotoxic chemotherapeutic agents such as BEP were found to alter stem cell properties of hAFSCs. Different methylation profiles change dynamically, which may explain such changes in cellular properties. Data also suggests that the fate of hAFSCs after treatment may depend upon the interplay between the miRNAs. Finally, our results demonstrate that hAFSCs might prove to be a suitable in-vitro model of stem cells to predict genetic and epigenetic modification due to the action of various drugs.
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Affiliation(s)
- Prabin Upadhyaya
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Alessandra Di Serafino
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Luca Sorino
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
| | - Patrizia Ballerini
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Centre of Aging Science and Translational Medicine (Ce.S.I.-Me.T.), G. d'Annunzio University, Chieti-Pescara, Italy
| | - Marco Marchisio
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Centre of Aging Science and Translational Medicine (Ce.S.I.-Me.T.), G. d'Annunzio University, Chieti-Pescara, Italy
| | - Laura Pierdomenico
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Centre of Aging Science and Translational Medicine (Ce.S.I.-Me.T.), G. d'Annunzio University, Chieti-Pescara, Italy
| | - Liborio Stuppia
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy
- Centre of Aging Science and Translational Medicine (Ce.S.I.-Me.T.), G. d'Annunzio University, Chieti-Pescara, Italy
| | - Ivana Antonucci
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G.d'Annunzio" University, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti, Italy.
- Centre of Aging Science and Translational Medicine (Ce.S.I.-Me.T.), G. d'Annunzio University, Chieti-Pescara, Italy.
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Orlando L, Loparco D, Fedele P, Schiavone P, Quaranta A, Caliolo C, Cinefra M, Rizzo P, Calvani N, Morleo A, Varriano R, Bonuso V, Falcone LL, Caloro M, Cinieri S. Final results of a prospective study of scalp cooling in preventing chemotherapy-induced alopecia. Future Oncol 2019; 15:3337-3344. [PMID: 31578891 DOI: 10.2217/fon-2019-0066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Alopecia is a distressing effect of cancer treatments. Our study examined efficacy and safety of scalp cooling to prevent chemotherapy-induced alopecia. Materials & methods: Early breast cancer patients candidate to anthracycline and/or taxane were eligible. Dean's alopecia scale was used to classify alopecia. Results: From February 2016 to November 2018, 127 women were enrolled; 55 (43.3%) received epirubicin/cyclophosphamide (4 EC 3 weeks) followed by paclitaxel (12 P weeks); 50 (39.4%) received 4 EC 3 weeks; 20 (15.7%) received 12 P weeks/trastuzumab and 2 docetaxel/cyclophosphamide (4 TC 3 weeks). The success rate was 71.7% (G0 21.3%, G1 31.5%, G2 18.9%). Frequent side effects were: coldness, headache, scalp pain and head heaviness. Conclusion: In our study, scalp cooling can prevent alopecia thus supporting the wider use in early breast cancer.
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Affiliation(s)
- Laura Orlando
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Dario Loparco
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Palma Fedele
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Paola Schiavone
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | | | - Chiara Caliolo
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | | | - Pietro Rizzo
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Nicola Calvani
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Addolorata Morleo
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Rosanna Varriano
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Valentina Bonuso
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | | | - Manuela Caloro
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
| | - Saverio Cinieri
- Medical Oncology Division, Antonio Perrino Hospital, Brindisi, Italy
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Haslam IS, Smart E. Chemotherapy-Induced Hair Loss: The Use of Biomarkers for Predicting Alopecic Severity and Treatment Efficacy. Biomark Insights 2019; 14:1177271919842180. [PMID: 31037027 PMCID: PMC6475836 DOI: 10.1177/1177271919842180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/08/2019] [Indexed: 01/08/2023] Open
Abstract
Damage to hair follicles following exposure to toxic chemotherapeutics can cause substantial hair loss, commonly known as chemotherapy-induced alopecia (CIA). Preventive therapies remain limited; however, recent advances in the use of scalp cooling technologies have proved successful in preventing or reducing hair loss in some patients. Further improvements in scalp cooling efficacy and/or development of novel treatments to prevent chemotherapy-induced hair loss are required. To achieve this, post-chemotherapy assessment of hair follicle damage markers, with and without scalp cooling, would provide invaluable mechanistic and prognostic information. At present, the availability of such data is extremely limited. This article describes the potential utility of a combination of biomarkers in assessing drug-induced alopecia and the protective potential of existing or new treatments. A greater understanding of the precise mechanisms of anti-CIA therapies through biomarker analysis would enhance the rationale, use, and development of such treatments.
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Affiliation(s)
- Iain S Haslam
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Eleanor Smart
- Centre for Dermatology Research, University of Manchester, Manchester, UK
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32
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Lim YC, Kim H, Lim SM, Kim JS. Genetic analysis of a novel antioxidant multi-target iron chelator, M30 protecting against chemotherapy-induced alopecia in mice. BMC Cancer 2019; 19:149. [PMID: 30760223 PMCID: PMC6374887 DOI: 10.1186/s12885-019-5323-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 01/25/2019] [Indexed: 12/21/2022] Open
Abstract
Background Chemotherapy-induced alopecia has been well documented as a cause of distress to patients undergoing cancer treatment. Almost all traditional chemotherapeutic agents cause severe alopecia. Despite advances in the treatment of chemotherapy-induced alopecia, there is no effective treatment for preventing chemotherapy-induced alopecia. Methods In the present study, we investigated the potential role of a multi-target iron chelator, M30 in protecting against cyclophosphamide-induced alopecia in C57BL/6 mice implanted with an osmotic pump. M30 enhanced hair growth and prevented cyclophosphamide-induced abnormal hair in the mice. Furthermore, we examined the gene expression profiles derived from skin biopsy specimens of normal mice, cyclophosphamide-treated mice, and cyclophosphamide treated mice with M30 supplement. Results The top genes namely Tnfrsf19, Ercc2, Lama5, Ctsl, and Per1 were identified by microarray analysis. These genes were found to be involved in the biological processes of hair cycle, hair cycle phase, hair cycle process, hair follicle development, hair follicle maturation, hair follicle morphogenesis, regulation of hair cycle. Conclusion Our study demonstrates that M30 treatment is a promising therapy for cyclophosphamide-induced alopecia and suggests that the top five genes have unique preventive effects in cyclophosphamide-induced transformation.
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Affiliation(s)
- Young-Cheol Lim
- Division of RI application, Korea Institute of Radiological and Medical Sciences, 75 Nowon-Gil, Gongneung-Dong, Nowon-Gu, Seoul, 01812, Korea.,Research support team, ANDIVA Inc., Chuncheon, Korea
| | - Hyeongi Kim
- Division of RI application, Korea Institute of Radiological and Medical Sciences, 75 Nowon-Gil, Gongneung-Dong, Nowon-Gu, Seoul, 01812, Korea
| | - Sang Moo Lim
- Division of RI application, Korea Institute of Radiological and Medical Sciences, 75 Nowon-Gil, Gongneung-Dong, Nowon-Gu, Seoul, 01812, Korea.,Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jin Su Kim
- Division of RI application, Korea Institute of Radiological and Medical Sciences, 75 Nowon-Gil, Gongneung-Dong, Nowon-Gu, Seoul, 01812, Korea. .,Radiological and Medico-Oncological Sciences, University of Science and Technology (UST), Seoul, Korea.
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Treatment of Glioblastoma (GBM) with the Addition of Tumor-Treating Fields (TTF): A Review. Cancers (Basel) 2019; 11:cancers11020174. [PMID: 30717372 PMCID: PMC6406491 DOI: 10.3390/cancers11020174] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 01/21/2023] Open
Abstract
Glioblastoma (GBM) is the most common primary brain tumor. Despite aggressive treatment, GBM almost always recurs. The current standard-of-care for treatment of newly diagnosed GBM has remained relatively unchanged since 2005: maximal safe resection followed by concomitant chemoradiation (CRT) with temozolomide (TMZ), and subsequent adjuvant TMZ. In 2011, the first-generation tumor treating fields (TTF) device, known at the time as the NovoTTF-100A System (renamed Optune), was approved by the Food and Drug Administration (FDA) for treatment of recurrent GBM. The TTF device was subsequently approved as an adjuvant therapy for newly-diagnosed GBM in 2015. The following is a review of the TTF device, including evidence supporting its use and limitations.
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A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS One 2019; 14:e0208118. [PMID: 30625139 PMCID: PMC6326423 DOI: 10.1371/journal.pone.0208118] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 11/12/2018] [Indexed: 12/02/2022] Open
Abstract
Purpose Many breast cancer patients suffer from chemotherapy-induced hair loss. Accurate information about temporal changes in chemotherapy-induced hair loss is important for supporting patients scheduled to receive chemotherapy, because it helps them to prepare. However, accurate information, on issues such as the frequency of hair loss after chemotherapy, when regrowth starts, the condition of regrown hair, and the frequency of incomplete hair regrowth, is lacking. This study aimed to clarify the long-term temporal changes in chemotherapy-induced hair loss using patient-reported outcomes for chemotherapy-induced hair loss. Methods We conducted a multicenter, cross-sectional questionnaire survey. Disease-free patients who had completed adjuvant chemotherapy consisting of anthracycline and/or taxanes for breast cancer within the prior 5 years were enrolled from 47 hospitals and clinics in Japan. Descriptive statistics were obtained in this study. The study is reported according to the STROBE criteria. Results The response rate was 81.5% (1511/1853), yielding 1478 questionnaires. Hair loss occurred in 99.9% of patients. The mean time from chemotherapy until hair loss was 18.0 days. Regrowth of scalp hair occurred in 98% of patients. The mean time from the completion of chemotherapy to the beginning of regrowth was 3.3 months. Two years after chemotherapy completion, the scalp-hair recovery rate was <30% in approximately 4% of patients, and this rate showed no improvement 5 years after chemotherapy. Eighty-four percent of the patients initially used wigs, decreasing to 47% by 1 year after chemotherapy and 15.2% after 2 years. The mean period of wig use was 12.5 months. However, a few patients were still using wigs 5 years after completing chemotherapy. Conclusions Our survey focused on chemotherapy-induced hair loss in breast cancer patients. We believe these results to be useful for patients scheduled to receive chemotherapy.
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Gianotti E, Razzini G, Bini M, Crivellaro C, Righi A, Darecchio S, Lui S, Basiricò ML, Cocconi S, Cagossi K, Ferrari A, Artioli F. Scalp Cooling in Daily Clinical Practice for Breast Cancer Patients Undergoing Curative Chemotherapy: A Multicenter Interventional Study. Asia Pac J Oncol Nurs 2019; 6:277-282. [PMID: 31259224 PMCID: PMC6518988 DOI: 10.4103/apjon.apjon_4_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective: Chemotherapy-induced alopecia is a common and distressful side effect, especially among breast cancer patients. Scalp cooling (SC) can reduce hair loss during anthracycline- and taxane-based chemotherapy. This study assessed the effectiveness of SC in daily clinical practice in three Italian oncology units. Methods: From 2014 to 2016, we prospectively included 220 female early-stage breast cancer patients undergoing curative chemotherapy in combination with SC using the Paxman device. Effectiveness was defined as the severity of hair loss according to the Common Terminology Criteria for Adverse Events Version 4.0 as follows: Grade 0, no hair loss; Grade 1, <50% hair loss not requiring a wig; and Grade 2, ≥50% hair loss at each cycle and at completion of chemotherapy. The tolerability and safety were also evaluated. Results: The overall success rate of SC (hair loss Grade 0–1) was 68%. Severe hair loss was avoided in 89% of women receiving taxane-based chemotherapy and in 78% of women receiving both anthracyclines and taxanes. Among women undergoing anthracycline-based chemotherapy, 47% experienced hair preservation. SC was well tolerated, as only 20 patients discontinued SC for reasons other than hair loss. Conclusions: Our study confirmed that SC provides a reliable chance for breast cancer patients to keep their hair during taxane- and/or anthracycline-based chemotherapy.
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Affiliation(s)
- Emilia Gianotti
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Giorgia Razzini
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Manuela Bini
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Caterina Crivellaro
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Angela Righi
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Simona Darecchio
- Oncology Unit, Guastalla Civil Hospital, Guastalla, Medicine Department Local Healt Unit, Reggio Emilia, Italy
| | - Stefania Lui
- Oncology Unit, Guastalla Civil Hospital, Guastalla, Medicine Department Local Healt Unit, Reggio Emilia, Italy
| | | | - Silvia Cocconi
- Oncology Unit, Parma Hospital, University of Parma, Parma, Italy
| | - Katia Cagossi
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Alessia Ferrari
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
| | - Fabrizio Artioli
- Unit of Medical Oncology, Carpi Civil Hospital, Carpi, Medicine Department, Local Health Unit, Modena, Italy
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Kang D, Kim IR, Choi EK, Im YH, Park YH, Ahn JS, Lee JE, Nam SJ, Lee HK, Park JH, Lee DY, Lacouture ME, Guallar E, Cho J. Permanent Chemotherapy-Induced Alopecia in Patients with Breast Cancer: A 3-Year Prospective Cohort Study. Oncologist 2018; 24:414-420. [PMID: 30120165 PMCID: PMC6519756 DOI: 10.1634/theoncologist.2018-0184] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/14/2018] [Indexed: 01/28/2023] Open
Abstract
Chemotherapy‐induced alopecia is (CIA) considered temporary; however, some patients report persistent alopecia several years after chemotherapy. Long‐term prospective data on the incidence and impact of permanent CIA is scarce. This article reports the results of a study conducted to estimate the long‐term incidence of persistent CIA in a cohort of breast cancer patients with measurements of hair volume and density before and after chemotherapy. Background. Although chemotherapy‐induced alopecia (CIA) is considered temporary, some patients report persistent alopecia several years after chemotherapy. There is, however, a paucity of long‐term prospective data on the incidence and impact of permanent CIA (PCIA). The objective of our study was to estimate the long‐term incidence of PCIA in a cohort of patients with breast cancer whose hair volume and density were measured prior to chemotherapy and who were followed for 3 years after chemotherapy. Materials and Methods. Prospective cohort study of consecutive patients ≥18 years of age with postoperative diagnosis of stage I–III breast cancer expected to receive adjuvant chemotherapy at the outpatient breast cancer clinic at the Samsung Medical Center in Seoul, Korea, from February 2012 to July 2013 (n = 61). Objective hair density and thickness were measured using a noninvasive bioengineering device. Results. The proportion of participants who had PCIA at 6 months and 3 years was 39.5% and 42.3%, respectively. PCIA was characterized in most patients by incomplete hair regrowth. Patients who received a taxane‐based regimen were more likely to experience PCIA compared with patients with other types of chemotherapy. At a 3‐year follow‐up, hair thinning was the most common problem reported by study participants (75.0%), followed by reduced hair volume (53.9%), hair loss (34.6%), and gray hair (34.6%). Conclusion. PCIA is a common adverse event of breast cancer adjuvant cytotoxic chemotherapy. Clinicians should be aware of this distressing adverse event and develop supportive care strategies to counsel patients and minimize its impact on quality of life. Implications for Practice. Knowledge of permanent chemotherapy‐induced alopecia, an under‐reported adverse event, should lead to optimized pretherapy counseling, anticipatory coping techniques, and potential therapeutic strategies for this sequela of treatment.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Im-Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Eun-Kyung Choi
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Young Hyuck Im
- Department of Hematology/Oncology, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Yeon Hee Park
- Department of Hematology/Oncology, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Jin Seok Ahn
- Department of Hematology/Oncology, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Comprehensive Cancer Center, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Comprehensive Cancer Center, Seoul, Korea
| | | | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Eliseo Guallar
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Comprehensive Cancer Center, Seoul, Korea
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Comprehensive Cancer Center, Seoul, Korea
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, Korea
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Mustoe MM, Lee CM, Melisko ME, Esserman LJ, Rugo HS. The DigniCap Scalp Cooling System and its use in the treatment of chemotherapy-induced alopecia. Future Oncol 2018; 14:2461-2469. [PMID: 30001151 DOI: 10.2217/fon-2018-0178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chemotherapy-induced alopecia remains an emotionally traumatic side effect for cancer patients that impacts the quality of life, may be protracted in duration and may influence treatment decisions. Scalp cooling has been shown to be effective in preventing chemotherapy-induced alopecia. The DigniCap Scalp Cooling System is designed to prevent hair loss by cooling the scalp to reduce the impact of chemotherapy on hair follicle cells. Recent studies have shown the safety, efficacy and low-grade toxicity of the DigniCap System with a 66.3% success rate in hair preservation (n = 106) relative to 0% in a nonrandomized control group according to a prospective pivotal study. Data also support improved quality of life in several domains. Two scalp cooling devices including the DigniCap are now US FDA cleared and can be offered as a part of standard of care.
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Affiliation(s)
- Mollie M Mustoe
- Helen Diller Family Comprehensive Center, University of California, San Francisco, CA 94115, USA
| | - Carmen M Lee
- Helen Diller Family Comprehensive Center, University of California, San Francisco, CA 94115, USA
| | - Michelle E Melisko
- Helen Diller Family Comprehensive Center, University of California, San Francisco, CA 94115, USA
| | - Laura J Esserman
- Helen Diller Family Comprehensive Center, University of California, San Francisco, CA 94115, USA
| | - Hope S Rugo
- Helen Diller Family Comprehensive Center, University of California, San Francisco, CA 94115, USA
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Jasra S, Anampa J. Anthracycline Use for Early Stage Breast Cancer in the Modern Era: a Review. Curr Treat Options Oncol 2018; 19:30. [PMID: 29752560 DOI: 10.1007/s11864-018-0547-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT Anthracycline-based regimens have been an important treatment component for patients with breast cancer. As demonstrated in the last Early Breast Cancer Trialists' Collaborative Group (EBCTCG) meta-analysis, anthracycline-based regimens decrease breast cancer mortality by 20-30%. Anthracycline toxicities include the rare-but potential morbid-cardiotoxicity or leukemogenic effect, and the almost universal-but very distressing-alopecia. Due to potential toxicities, and large number of patients being exposed, several worldwide trials have re-examined the role of anthracycline-based regimens in the management of breast cancer. Current literature supports that anthracyclines are not required for all patients with breast cancer and should be avoided in those with high cardiac risk. Recent results from the ABC trials suggest that anthracyclines should not be spared for patients with triple negative breast cancer (regardless of axillary node involvement) or HER2-/ER+ with significant node involvement. Based on current literature, for HER2-negative patients with low-risk breast cancer, anthracyclines could be spared with regimens such as cyclophosphamide, methotrexate, and fluorouracil (CMF) or docetaxel and cyclophosphamide (TC). Patients with intermediate or high-risk breast cancer should be considered for anthracycline-based regimens based on other factors such as age, comorbidities, tumor grade, lymphovascular invasion, and genomic profiling. Patients with HER2-positive breast cancer with low risk could be treated with paclitaxel and trastuzumab. For the remaining patients with HER2 overexpression, while docetaxel, carboplatin, and trastuzumab (TCH) has demonstrated to improve disease-free survival (DFS), anthracycline-containing regimens should be discussed, especially for those with very high-risk breast cancer. Although several biomarkers, such as topoisomerase II (TOP2A) and chromosome 17 centromeric duplication (Ch17CEP) have been proposed to predict benefit from anthracycline regimens, further research is required to delineate their proper utility in the clinical setting.
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Affiliation(s)
- Sakshi Jasra
- Department of Oncology, Section of Breast Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jesus Anampa
- Department of Oncology, Section of Breast Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. .,Department of Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 1695 Eastchester Rd., Bronx, NY, 10461, USA.
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Freites-Martinez A, Shapiro J, Goldfarb S, Nangia J, Jimenez JJ, Paus R, Lacouture ME. Hair disorders in patients with cancer. J Am Acad Dermatol 2018; 80:1179-1196. [PMID: 29660422 DOI: 10.1016/j.jaad.2018.03.055] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/07/2018] [Accepted: 03/18/2018] [Indexed: 01/04/2023]
Abstract
Cytotoxic chemotherapies, molecularly targeted therapies, immunotherapies, radiotherapy, stem cell transplants, and endocrine therapies may lead to hair disorders, including alopecia, hirsutism, hypertrichosis, and pigmentary and textural hair changes. The mechanisms underlying these changes are varied and remain incompletely understood, hampering the development of preventive or therapeutic guidelines. The psychosocial impact of chemotherapy-induced alopecia has been well documented primarily in the oncology literature; however, the effect of other alterations, such as radiation-induced alopecia, hirsutism, and changes in hair color or texture on quality of life have not been described. This article reviews clinically significant therapy-related hair disorders in oncology patients, including the underlying pathophysiological mechanisms, severity grading scales, patient-reported quality of life questionnaires, management strategies, and future translational research opportunities.
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Affiliation(s)
- Azael Freites-Martinez
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Shari Goldfarb
- Breast Cancer Medicine Service, Department of Medicine, Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Julie Nangia
- Lester and Sue Smith Breast Center, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Joaquin J Jimenez
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida; Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Ralf Paus
- Dermatology Research Centre, University of Manchester, Manchester, United Kingdom; National Institute of Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom; Department of Dermatology, University of Munster, Munster, Germany
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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Komen MMC, van den Hurk CJG, Nortier JWR, van der Ploeg T, Smorenburg CH, van der Hoeven JJM. Patient-reported outcome assessment and objective evaluation of chemotherapy-induced alopecia. Eur J Oncol Nurs 2018; 33:49-55. [PMID: 29551177 DOI: 10.1016/j.ejon.2018.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/06/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Alopecia is one of the most distressing side effects of chemotherapy. Evaluating and comparing the efficacy of potential therapies to prevent chemotherapy-induced alopecia (CIA) has been complicated by the lack of a standardized measurement for hair loss. In this study we investigated the correlation between patient-reported outcome assessments and quantitative measurement with the hair check to assess CIA in clinical practice. METHOD Scalp cooling efficacy was evaluated by patients by World Health Organisation (WHO) of CIA, Visual Analogue Scale (VAS) and wig use. The Hair Check was used to determine the amount of hair (in mm2) per unit of scalp skin area (in cm2) (Hair Mass Index, HMI). CIA was also evaluated by doctors, nurses and hairdressers. RESULTS Baseline HMI was not predictive for hair loss. HMI declined throughout all chemotherapy cycles, which was not reflected by patient-reported measures. HMI correlated with patient-reported hair quantity before the start of the therapy, but not with WHO and/or VAS during therapy. Patient's opinion correlated moderately with the opinion of doctors and nurses (ρ = 0.50-0.56 respectively), but strongly with hair dressers (ρ = 0.70). CONCLUSIONS The Hair check is suitable to quantify the amount of hair loss and could complement research on refining outcome of scalp cooling, but the patient's opinion should be considered as the best method to assess hair loss in clinical practice. TRIAL REGISTRATION Trialregister.nl NTR number 3082.
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Affiliation(s)
- Manon M C Komen
- Northwest Clinics, Department of Internal Medicine and Medical Oncology, PO Box 501, 1800 AM, Alkmaar, The Netherlands.
| | - Corina J G van den Hurk
- Comprehensive Cancer Organisation The Netherlands, PO Box 19079, 3501 DB, Utrecht, The Netherlands.
| | - Johan W R Nortier
- Leiden University Medical Centre, Department of Medical Oncology, PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - T van der Ploeg
- Northwest Clinics, Science Department, PO Box 501, 1800 AM, Alkmaar, The Netherlands.
| | - Carolien H Smorenburg
- Antoni van Leeuwenhoek, Department of Medical Oncology, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Jacobus J M van der Hoeven
- Radboud University Medical Centre, Department of Medical Oncology, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
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Rugo HS, Voigt J. Scalp Hypothermia for Preventing Alopecia During Chemotherapy. A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Breast Cancer 2018; 18:19-28. [DOI: 10.1016/j.clbc.2017.07.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 04/04/2017] [Accepted: 07/16/2017] [Indexed: 11/16/2022]
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Dunnill CJ, Al-Tameemi W, Collett A, Haslam IS, Georgopoulos NT. A Clinical and Biological Guide for Understanding Chemotherapy-Induced Alopecia and Its Prevention. Oncologist 2017; 23:84-96. [PMID: 28951499 DOI: 10.1634/theoncologist.2017-0263] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022] Open
Abstract
Chemotherapy-induced alopecia (CIA) is the most visibly distressing side effect of commonly administered chemotherapeutic agents. Because psychological health has huge relevance to lifestyle, diet, and self-esteem, it is important for clinicians to fully appreciate the psychological burden that CIA can place on patients. Here, for the first time to our knowledge, we provide a comprehensive review encompassing the molecular characteristics of the human hair follicle (HF), how different anticancer agents damage the HF to cause CIA, and subsequent HF pathophysiology, and we assess known and emerging prevention modalities that have aimed to reduce or prevent CIA. We argue that, at present, scalp cooling is the only safe and U.S. Food and Drug Administration-cleared modality available, and we highlight the extensive available clinical and experimental (biological) evidence for its efficacy. The likelihood of a patient that uses scalp cooling during chemotherapy maintaining enough hair to not require a wig is approximately 50%. This is despite different types of chemotherapy regimens, patient-specific differences, and possible lack of staff experience in effectively delivering scalp cooling. The increased use of scalp cooling and an understanding of how to deliver it most effectively to patients has enormous potential to ease the psychological burden of CIA, until other, more efficacious, equally safe treatments become available. IMPLICATIONS FOR PRACTICE Chemotherapy-induced alopecia (CIA) represents perhaps the most distressing side effect of chemotherapeutic agents and is of huge concern to the majority of patients. Scalp cooling is currently the only safe option to combat CIA. Clinical and biological evidence suggests improvements can be made, including efficacy in delivering adequately low temperature to the scalp and patient-specific cap design. The increased use of scalp cooling, an understanding of how to deliver it most effectively, and biological evidence-based approaches to improve its efficacy have enormous potential to ease the psychological burden of CIA, as this could lead to improvements in treatment and patient quality-of-life.
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Affiliation(s)
- Christopher John Dunnill
- Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
| | - Wafaa Al-Tameemi
- Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Andrew Collett
- Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
| | - Iain Stuart Haslam
- Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
| | - Nikolaos Theodoros Georgopoulos
- Department of Biological Sciences, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
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Saed S, Ibrahim O, Bergfeld WF. Hair camouflage: A comprehensive review. Int J Womens Dermatol 2017; 2:122-127. [PMID: 28492024 PMCID: PMC5418894 DOI: 10.1016/j.ijwd.2016.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 09/11/2016] [Indexed: 11/24/2022] Open
Abstract
Hair is venerated, cherished, and desired in societies throughout the world. Both women and men express their individual identities through their hairstyles. Healthy hair contributes to successful social assimilation, employment, and overall quality of life. Therefore, hair loss can have detrimental effects on almost every aspect of a person’s life. In this review, we discuss the myriad of options that aid in concealing and camouflaging hair loss to facilitate a healthier-appearing scalp. Camouflage options for patients who suffer from hair loss include full or partial wigs, hair extensions, concealing powders and sprays, surgical tattoos, and hair transplants. We describe these modalities in detail and discuss their respective advantages and disadvantages.
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Affiliation(s)
| | - Omer Ibrahim
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wilma F Bergfeld
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
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Barrón-Hernández YL, Tosti A. Bimatoprost for the treatment of eyelash, eyebrow and scalp alopecia. Expert Opin Investig Drugs 2017; 26:515-522. [DOI: 10.1080/13543784.2017.1303480] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
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Saed S, Ibrahim O, Bergfeld WF. Hair camouflage: A comprehensive review. Int J Womens Dermatol 2017; 3:S75-S80. [PMID: 28492045 PMCID: PMC5419059 DOI: 10.1016/j.ijwd.2017.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 09/11/2016] [Indexed: 12/30/2022] Open
Abstract
Hair is venerated, cherished, and desired in societies throughout the world. Both women and men express their individual identities through their hairstyles. Healthy hair contributes to successful social assimilation, employment, and overall quality of life. Therefore, hair loss can have detrimental effects on almost every aspect of a person’s life. In this review, we discuss the myriad of options that aid in concealing and camouflaging hair loss to facilitate a healthier-appearing scalp. Camouflage options for patients who suffer from hair loss include full or partial wigs, hair extensions, concealing powders and sprays, surgical tattoos, and hair transplants. We describe these modalities in detail and discuss their respective advantages and disadvantages.
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Affiliation(s)
| | - Omer Ibrahim
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wilma F Bergfeld
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
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Rugo HS, Klein P, Melin SA, Hurvitz SA, Melisko ME, Moore A, Park G, Mitchel J, Bågeman E, D'Agostino RB, Ver Hoeve ES, Esserman L, Cigler T. Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer. JAMA 2017; 317:606-614. [PMID: 28196257 PMCID: PMC5639721 DOI: 10.1001/jama.2016.21038] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Chemotherapy-induced alopecia is a common and distressing adverse effect. In previous studies of scalp cooling to prevent chemotherapy-induced alopecia, conclusions have been limited. OBJECTIVES To evaluate whether use of a scalp cooling system is associated with a lower amount of hair loss among women receiving specific chemotherapy regimens for early-stage breast cancer and to assess related changes in quality of life. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study conducted at 5 US medical centers of women with stage I or II breast cancer receiving adjuvant or neoadjuvant chemotherapy regimens excluding sequential or combination anthracycline and taxane (106 patients in the scalp cooling group and 16 in the control group; 14 matched by both age and chemotherapy regimen). The study was conducted between August 2013 and October 2014 with ongoing annual follow-up for 5 years. EXPOSURES Use of a scalp cooling system. Scalp cooling was initiated 30 minutes prior to each chemotherapy cycle, with scalp temperature maintained at 3°C (37°F) throughout chemotherapy and for 90 minutes to 120 minutes afterward. MAIN OUTCOMES AND MEASURES Self-estimated hair loss using the Dean scale was assessed 4 weeks after the last dose of chemotherapy by unblinded patient review of 5 photographs. A Dean scale score of 0 to 2 (≤50% hair loss) was defined as treatment success. A positive association between scalp cooling and reduced risk of hair loss would be demonstrated if 50% or more of patients in the scalp cooling group achieved treatment success, with the lower bound of the 95% CI greater than 40% of the success proportion. Quality of life was assessed at baseline, at the start of the last chemotherapy cycle, and 1 month later. Median follow-up was 29.5 months. RESULTS Among the 122 patients in the study, the mean age was 53 years (range, 28-77 years); 77.0% were white, 9.0% were black, and 10.7% were Asian; and the mean duration of chemotherapy was 2.3 months (median, 2.1 months). No participants in the scalp cooling group received anthracyclines. Hair loss of 50% or less (Dean score of 0-2) was seen in 67 of 101 patients (66.3%; 95% CI, 56.2%-75.4%) evaluable for alopecia in the scalp cooling group vs 0 of 16 patients (0%) in the control group (P < .001). Three of 5 quality-of-life measures were significantly better 1 month after the end of chemotherapy in the scalp cooling group. Of patients who underwent scalp cooling, 27.3% (95% CI, 18.0%-36.6%) reported feeling less physically attractive compared with 56.3% (95% CI, 31.9%-80.6%) of patients in the control group (P = .02). Of the 106 patients in the scalp cooling group, 4 (3.8%) experienced the adverse event of mild headache and 3 (2.8%) discontinued scalp cooling due to feeling cold. CONCLUSIONS AND RELEVANCE Among women undergoing non-anthracycline-based adjuvant chemotherapy for early-stage breast cancer, the use of scalp cooling vs no scalp cooling was associated with less hair loss at 4 weeks after the last dose of chemotherapy. Further research is needed to assess outcomes after patients receive anthracycline regimens, longer-term measures of alopecia, and adverse effects. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01831024.
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Affiliation(s)
- Hope S Rugo
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
| | - Paula Klein
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Susan Anitra Melin
- Wake Forest Baptist Health Medical Center, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sara A Hurvitz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Michelle E Melisko
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
| | - Anne Moore
- Weill Cornell Medical College, New York, New York
| | - Glen Park
- Target Health Inc, New York, New York
| | | | | | | | - Elizabeth S Ver Hoeve
- Columbia University, New York, New York10Now with the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Laura Esserman
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
| | - Tessa Cigler
- Weill Cornell Medical College, New York, New York
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Fehr MK, Welter J, Sell W, Jung R, Felberbaum R. Sensor-controlled scalp cooling to prevent chemotherapy-induced alopecia in female cancer patients. ACTA ACUST UNITED AC 2016; 23:e576-e582. [PMID: 28050147 DOI: 10.3747/co.23.3200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cooling systems demonstrate varying results in terms of effectiveness and tolerability. METHODS For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (who) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy. RESULTS Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel-carboplatin experienced less alopecia. The compound successful outcome ("no head covering" plus "who grade 0/1") was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel-cyclophosphamide or 6 cycles of paclitaxel-carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel-doxorubicin-cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil-epirubicin-cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin-cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens. CONCLUSIONS The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the patient. Use of a compound endpoint with subjective and objective measures provides insightful and practical information when counselling patients.
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Affiliation(s)
- M K Fehr
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - J Welter
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - W Sell
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - R Jung
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - R Felberbaum
- Department of Obstetrics and Gynecology, Clinic of Kempten-Oberallgäu, Germany
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Komen MMC, Smorenburg CH, Nortier JWR, van der Ploeg T, van den Hurk CJG, van der Hoeven JJM. Results of scalp cooling during anthracycline containing chemotherapy depend on scalp skin temperature. Breast 2016; 30:105-110. [PMID: 27689316 DOI: 10.1016/j.breast.2016.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 08/16/2016] [Accepted: 09/10/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES The success of scalp cooling in preventing or reducing chemotherapy induced alopecia (CIA) is highly variable between patients undergoing similar chemotherapy regimens. A decrease of the scalp skin temperature seems to be an important factor, but data on the optimum temperature reached by scalp cooling to prevent CIA are lacking. This study investigated the relation between scalp skin temperature and its efficacy to prevent CIA. MATERIALS AND METHODS In this explorative study, scalp skin temperature was measured during scalp cooling in 62 breast cancer patients undergoing up to six cycles of anthracycline containing chemotherapy. Scalp skin temperature was measured by using two thermocouples at both temporal sides of the head. The primary end-point was the need for a wig or other head covering. RESULTS Maximal cooling was reached after 45 min and was continued for 90 min after chemotherapy infusion. The scalp skin temperature after 45 min cooling varied from 10 °C to 31 °C, resulting in a mean scalp skin temperature of 19 °C (SEM: 0,4). Intrapersonal scalp skin temperatures during cooling were consistent for each chemotherapy cycle (ANOVA: P = 0,855). Thirteen out of 62 patients (21%) did not require a wig or other head covering. They appeared to have a significantly lower mean scalp skin temperature (18 °C; SEM: 0,7) compared to patients with alopecia (20 °C; SEM: 0,5) (P = 0,01). CONCLUSION The efficacy of scalp cooling during chemotherapy is temperature dependent. A precise cut-off point could not be detected, but the best results seem to be obtained when the scalp temperature decreases below 18 °C. TRIALREGISTER. NL NTR NUMBER 3082.
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Affiliation(s)
- M M C Komen
- Department of Internal Medicine and Medical Oncology, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands.
| | - C H Smorenburg
- Department of Medical Oncology, Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
| | - J W R Nortier
- Department of Medical Oncology, Leiden University Medical Centre, PO Box 9600, Leiden, 2300 RC, The Netherlands.
| | - T van der Ploeg
- Science Department, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands.
| | - C J G van den Hurk
- Comprehensive Cancer Organisation the Netherlands, PO Box 231, Eindhoven, 5600 AE, The Netherlands.
| | - J J M van der Hoeven
- Department of Medical Oncology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
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Arujuna N, Topham E, Atkinson L, George S, Derrick E, Farrant P. Bimatoprost solution 0·03% topical application to the eyelid margin for the treatment of eyelash hypotrichosis. Br J Dermatol 2016; 174:1416-7. [DOI: 10.1111/bjd.14472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N.R. Arujuna
- Dermatology Brighton and Sussex University Hospitals Brighton U.K
| | - E.J. Topham
- Dermatology Brighton and Sussex University Hospitals Brighton U.K
| | - L.R. Atkinson
- Dermatology Brighton and Sussex University Hospitals Brighton U.K
| | - S.M.C. George
- Dermatology Eastbourne District General Hospital Eastbourne U.K
| | - E.K. Derrick
- Dermatology Brighton and Sussex University Hospitals Brighton U.K
| | - P.B.J. Farrant
- Dermatology Brighton and Sussex University Hospitals Brighton U.K
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Cozzani E, Iurlo A, Merlo G, Cattaneo D, Burlando M, Pierri I, Gugliotta L, Parodi A. Essential Thrombocythemia: The Dermatologic Point of View. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:739-47. [PMID: 26432058 DOI: 10.1016/j.clml.2015.08.086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/18/2015] [Accepted: 08/24/2015] [Indexed: 12/12/2022]
Abstract
Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by an increase in blood platelets and dominated by a predisposition to vascular events. Cutaneous manifestations can complicate its course. itching has been the most common symptom reported; however, the percentage has ranged from 3% to 46%, depending on the survey. Erythromelalgia is found in 6% of cases, and livedo reticularis, minor bleeding, acrocyanosis, and Raynaud's phenomenon are rare manifestations. It is important to recognize and treat these events, because they can affect patients' quality of life and could worsen the prognosis. In addition to skin involvement as a possible sign of ET, the treatment of ET can be associated with cutaneous complications. Hydroxycarbamide, interferon-alfa, and anagrelide can induce different skin lesions. Hydroxycarbamide has been associated with major complications, including painful leg ulcers and actinic keratoses. Minor events include alopecia and hyperpigmentation. Xerosis, pruritus, and photosensitivity are some of the complications reported by patients treated with interferon-alfa. Anagrelide has proved to be associated with fewer dermatologic effects, only detected in single cases. Knowledge of the ET cutaneous manifestations, together with the clinical examination findings, can result in an earlier diagnosis and the start of effective treatment.
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Affiliation(s)
- Emanuele Cozzani
- Di. S. Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria, San Martino-IST, Genoa, Italy.
| | - Alessandra Iurlo
- Oncohematology Division, Oncohematology Unit of the Elderly, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Giulia Merlo
- Di. S. Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria, San Martino-IST, Genoa, Italy
| | - Daniele Cattaneo
- Oncohematology Division, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Martina Burlando
- Di. S. Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria, San Martino-IST, Genoa, Italy
| | - Ivana Pierri
- Department of Hematology and Oncology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - Luigi Gugliotta
- Institute of Hematology "L. e A. Seragnoli", S. Orsola Malpighi University Hospital, Bologna, Italy
| | - Aurora Parodi
- Di. S. Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria, San Martino-IST, Genoa, Italy
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