Assessment of quality of life and treatment outcomes of patients with persistent postchemotherapy alopecia Journal Article
| Authors: | Freites-Martinez, A.; Chan, D.; Sibaud, V.; Shapiro, J.; Fabbrocini, G.; Tosti, A.; Cho, J.; Goldfarb, S.; Modi, S.; Gajria, D.; Norton, L.; Paus, R.; Cigler, T.; Lacouture, M. E. |
| Article Title: | Assessment of quality of life and treatment outcomes of patients with persistent postchemotherapy alopecia |
| Abstract: | Importance: Persistent alopecia occurs in a subset of patients undergoing chemotherapy, yet the quality of life (QOL) of these patients and their response to therapy have not been described in a large patient cohort. Objective: To characterize the clinical presentation of patients with persistent chemotherapy-induced alopecia (pCIA) or endocrine therapy-induced alopecia after chemotherapy (EIAC) and their QOL and treatment outcomes. Design, Setting, and Participants: A retrospective multicenter cohort of 192 women with cancer treated with cytotoxic agents who received a clinical diagnosis of persistent alopecia (98 with pCIA and 94 with EIAC) between January 1, 2009, and July 31, 2017, was analyzed. All patients were from the dermatology service in 2 comprehensive cancer centers and 1 tertiary-care hospital. Data on demographics, chemotherapy regimens, severity, clinical patterns, and response to hair-growth promoting agents were assessed. Data from the Hairdex questionnaire were used to assess the QOL of patients with alopecia. Main Outcomes and Measures: The clinical presentation, response to dermatologic therapy, and QOL of patients with pCIA were assessed and compared with those of patients with EIAC. Results: A total of 98 women with pCIA (median age, 56.5 years [range, 18-83 years]) and 94 women with EIAC (median age, 56 years [range, 29-84 years]) were included. The most common agents associated with pCIA were taxanes for 80 patients (82%); the most common agents associated with EIAC were aromatase inhibitors for 58 patients (62%). Diffuse alopecia was predominant in patients with pCIA compared with patients with EIAC (31 of 75 [41%] vs 23 of 92 [25%]; P =.04), with greater severity (Common Terminology Criteria for Adverse Events, version 4.0, grade 2) among patients with pCIA (29 of 75 [39%] vs 12 of 92 [13%]; P <.001). A negative emotional effect was reported by both groups. After treatment with topical minoxidil or spironolactone, moderate to significant improvement was observed for 36 of 54 patients with pCIA (67%) and for 32 of 42 patients with EIAC (76%). Conclusions and Relevance: Persistent chemotherapy-induced alopecia is frequently more severe and diffuse when compared with EIAC, and both groups of patients experienced a negative effect. A modest benefit was observed with dermatologic therapy. Additional studies are warranted to develop effective strategies for prevention and effective therapy for pCIA and EIAC.. © 2019 American Medical Association. All rights reserved. |
| Journal Title: | JAMA Dermatology |
| Volume: | 155 |
| Issue: | 6 |
| ISSN: | 2168-6068 |
| Publisher: | American Medical Association |
| Date Published: | 2019-06-01 |
| Start Page: | 724 |
| End Page: | 728 |
| Language: | English |
| DOI: | 10.1001/jamadermatol.2018.5071 |
| PROVIDER: | scopus |
| PMCID: | PMC6563563 |
| PUBMED: | 30840033 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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