Recommendation – Who can use DigniCap™?
Based on the data reviewed, the following recommendations identify the right candidates to receive scalp cooling with the DigniCap™ system:
a) Scalp cooling can be routinely used for both palliative and adjuvant settings in a wide variety of solid tumors rarely metastasizing to the scalp, such as breast, ovarian/endometrial, prostate, lung, esophageal/stomach, colon.
b) Scalp cooling can be used on a wide selection of chemotherapy regimens, particularly when anthracyclines (doxorubicin, epirubicin) or taxanes (paclitaxel, docetaxel) are used. The results are higher in single-drug therapy than in combination therapy, e.g. when etoposide and cyclophosphamide are added).
(Please download Compatible Drug Regimens and Recommended Cooling time for the DigniCap™ system).
Who should not use scalp cooling?
a)
Scalp cooling should be avoided in patients with hematological malignancies with hematogenic metastases (e.g. myeloma, leukemia, lymphoma) due to possible risk of scalp metastases. However, in certain cases it may feel appropriate to offer scalp cooling to some of these patients for reasons of quality of life.
b)
Scalp cooling is not recommended in cases of migraine and violent aversion to cold.
c)
Scalp cooling is not recommended for some chemotherapy treatments where the drug stays in the body for a long time: for example, continuous treatment through a pump for many hours.
d)
Scalp cooling is not recommended in patients who have impaired liver function or the presence of liver metastases, as the hair-protective effect of scalp cooling may be low due to the longer time it takes to eliminate the drug.
Compatible chemotherapy drugs to scalp cooling: