Abstract PO4-11-06: Survey of Questionnaires on the Efficacy and Cost of Scalp Cooling Devices in Breast Cancer Patients
Authors: Kotani Haruru , Kureyama Nari , Kusudo Maho , Komaki Rie , Nakakami Akira , Endo Yuka , Kataoka Ayumi , Yoshimura Akiyo , Hattori Masaya , Sawaki Masataka , Iwata Hiroji 
Published: May 2024

&lt; Background &gt; Scalp cooling devices have demonstrated effectiveness in mitigating chemotherapy-induced alopecia, with an approximate reported success rate of 50% in hair preservation. Nevertheless, their utilization may lead to adverse effects and financial burdens for patients. Our institution introduced the Paxman scalp cooling system in 2021 for breast cancer patients undergoing perioperative chemotherapy, with its application extending to over 120 cases. An out-of-pocket expense of 16,000 yen ($110) per chemotherapy session is required, separate from insurance-covered treatments. We conducted a retrospective evaluation using patient questionnaires and medical records to assess the efficacy and cost-related satisfaction concerning scalp cooling devices.

&lt; Methods &gt; The subjects consisted of breast cancer patients who had undergone at least one session of chemotherapy with scalp cooling devices at our institution. Objective assessment of hair preservation was performed through head photographs taken during the usage of the cooling devices and recorded in the medical charts. The evaluation was carried out using CTCAE version 4, and statistical analysis of relationships was conducted utilizing Stata version 18 and the χ² test.

&lt; Results &gt; Responses were collected from 91 patients (survey response rate: 96%). The median age of the patients was 51 years (range: 28-80). The regimens of chemotherapy included anthracycline-based (A) in 10 patients (11%), taxane-based (T) in 19 patients (21%), A-T combination in 57 patients (63%), and HER2-targeted therapy in 38 patients (42%). The results of questionnaire revealed, besides scalp cooling, patients incurred a median cost of 131,000 yen($922) for wigs and 10,000 yen($70) for hair care and other expenses. 61 individuals (67%) completed the scalp cooling treatment during the chemotherapy. The reasons for discontinuation of scalp cooling were mainly discomfort due to tightness (33%), followed by the time-consuming nature of the process (30%), hair loss (26%), and excessive cold sensation (26%) (Multiple answers allowed). Regarding the benefits and drawbacks of scalp cooling devices, 50 patients (56%) expressed satisfaction for scalp cooling, 26 patients (29%) had neutral feelings, 14 patients (16%) expressed unsatisfied, and one response was unknown. Regarding the device's cost, 14 patients (16%) were satisfied, 35 patients (40%) were neutral, 39 patients (44%) were unsatisfied, and three responses was unknown. Among the 52 patients who continued using the device until their final chemotherapy session and could assess the head photographs, the hair loss grades were as follows: grade 0 in 9 patients (17%), grade 1 in 22 patients (42%), and grade 2 in 21 patients (40%). A correlation was observed between the objective hair loss grade and satisfaction with the device's efficacy (p &lt; 0.01), while no significant correlation was found between satisfaction and the cost (p = 0.21) (attached table).

&lt; Discussion &gt; Although more than half of the patients who utilized scalp cooling devices expressed satisfaction with their efficacy, merely 16% expressed satisfaction with the associated costs. Addressing patient financial burdens, including expand to insurance coverage, becomes imperative for future considerations.

Table. The relation between hair preservation and satisfaction for efficacy and cost. A correlation was observed between the objective hair loss grade and satisfaction with the device's efficacy (p &lt; 0.01), while no significant correlation was found between satisfaction and the cost (p = 0.21)

Citation Format: Haruru Kotani, Nari Kureyama, Maho Kusudo, Rie Komaki, Akira Nakakami, Yuka Endo, Ayumi Kataoka, Akiyo Yoshimura, Masaya Hattori, Masataka Sawaki, Hiroji Iwata. Survey of Questionnaires on the Efficacy and Cost of Scalp Cooling Devices in Breast Cancer Patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-11-06.