Results of 20- versus 45-min post-infusion scalp cooling time in the prevention of docetaxel-induced alopecia

Support Care Cancer. 2016 Jun;24(6):2735-41. doi: 10.1007/s00520-016-3084-7. Epub 2016 Jan 25.


Purpose: For patients, chemotherapy-induced alopecia (CIA) is one of the most distressing side effects of treatment. Scalp cooling can prevent or minimise CIA; the results may depend on the duration of cooling. Since a previous study on post-infusion cooling time in patients treated with docetaxel chemotherapy found no difference between 90 and 45 min, we investigated whether hair-preserving results could be maintained with a shorter post-infusion cooling time.

Methods: In this prospective, multi-centre randomised study, 134 patients who started treatment with docetaxel 75-100 mg/m(2) in a 3-weekly schedule were randomly assigned in a 1:1 ratio to a post-infusion cooling time of 45 or 20 min. The primary end point was the need for a wig or other head covering as assessed by the patient. A visual analogue scale (VAS) with a range from 0 (not tolerable) to 10 (very tolerable) was used to measure tolerance.

Results: Scalp cooling results were similar for 45- and 20-min post-infusion cooling times. Thirty-three out of 45 patients (73 %) treated with 20 min of post-infusion cooling did not need a form of head covering, compared with 41 out of 52 patients (79 %) treated with 45 min of post-infusion cooling (p = 0.5). The procedure was well tolerated (mean visual analogue score 8.3). Six patients stopped due to intolerance during the first treatment cycle.

Conclusions: A 20-min post-infusion cooling time is effective and tolerable for patients treated with scalp cooling to prevent docetaxel-induced alopecia.

Trial registration: Identifier, NTR 1856.

Keywords: Alopecia; Chemotherapy; Docetaxel; Scalp cooling; Side effects.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alopecia / chemically induced
  • Alopecia / prevention & control*
  • Antineoplastic Agents / adverse effects*
  • Docetaxel
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Female
  • Humans
  • Hypothermia, Induced / methods*
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Scalp*
  • Taxoids / adverse effects*


  • Antineoplastic Agents
  • Taxoids
  • Docetaxel