Evidence map›Paper›PMID 41269388›Full record

SynthesisBreast cancer research and treatment2025

Adverse effects of scalp cooling for the reduction of chemotherapy-induced alopecia: A systematic review and meta-analysis.

Caitlin A Kearney, Anna L Brinks, Carli D Needle, Samrachana Adhikari, Douglas K Marks, Jerry Shapiro, Ian W Tattersall, Kristen I Lo Sicco, Mario E Lacouture

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Caitlin A KearneyThe Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA. caitlin.kearney@nyulangone.org.
Anna L BrinksThe Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.
Carli D NeedleThe Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.
Samrachana AdhikariDepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Douglas K MarksDivision of Oncology & Hematology, Department of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY, USA.
Jerry ShapiroThe Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.
Ian W TattersallThe Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.
Kristen I Lo Sicco *The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.
Mario E Lacouture *The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, 222 East 41 Street, 16 Floor, New York, NY, 10016, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChemotherapy-induced alopecia (CIA) affects approximately 65% of patients receiving chemotherapy and has a negative impact on quality of life (QoL). Scalp cooling (SC) is the only FDA-cleared intervention for CIA. This systematic review and meta-analysis evaluated SC adverse events (AEs), reasons for discontinuation, and scalp metastasis incidence.

methodsMeta-analyses using random-effects models estimated pooled prevalences of SC AEs, SC discontinuation, and reasons for discontinuation. A generalized linear mixed model was used to estimate the incidence of scalp metastasis.

resultsSixty-seven studies met the inclusion criteria. The most common AEs were generalized chills (42%, 95% confidence interval (CI) 26-58%), cap heaviness (35%, 95% CI 18-52%), and headache (30%, 95% CI 21-39%). The SC discontinuation rate was 18% (95% CI 13-23%). The most common reasons for discontinuation were progressive alopecia (15%, 95% CI 10-20%) and reasons unrelated to SC (9%, 95% CI 5-13%). The most frequent AEs leading to SC discontinuation were headache (4%, 95% CI 2-6%), cold intolerance (4%, 95% CI 3-5%), and general discomfort (4%, 95% CI 2-7%). Secondary analysis of scalp metastases yielded an incidence of 0.15% (95% CI 0.05-0.47%). Analysis of FDA Manufacturer and User Facility Device Experience (MAUDE) database medical device reports revealed that user error contributed to cold thermal injuries. Prevalence estimates were limited by significant heterogeneity between studies, reflecting variations in study methodology and real-world SC practices.

conclusionSC is generally well tolerated with minimal safety concerns. Clinical comfort strategies like supportive medications and improved patient education could enhance SC tolerability and support its implementation.

Indexed as

AlopeciaAntineoplastic AgentsHypothermia, InducedNeoplasmsScalpFemaleHumansIncidenceQuality of LifeAntineoplastic AgentsAdverse effectChemotherapy-induced alopeciaCold capQuality of lifeSafetyScalp cooling

Identifiers

PMID41269388

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.