Comparative efficacy of interventions for preventing chemotherapy-induced alopecia: a systematic review and network meta-analysis.
Kansak Boonpattharatthiti, Suwapat Lawin, Pongsapat Limhengsin et al.
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In 30 seconds
This systematic review and network meta-analysis compared preventive interventions for chemotherapy-induced alopecia in cancer patients, including 12 randomized trials with 736 participants and nine intervention groups. Prolonged scalp hypothermia (> 90 min post-chemotherapy) ranked highest for hair preservation and was associated with better preservation than usual care (RR = 24.66; 95%CI = 7.07-86.05). Its apparent advantage over short-duration hypothermia was not statistically significant. The authors rated most studies at high risk of bias and the overall certainty of evidence as low to very low.
Key findings
- Prolonged scalp hypothermia improved hair preservation versus usual care (RR = 24.66; 95%CI = 7.07-86.05; low certainty).
- Compared with traditional scalp hypothermia, prolonged hypothermia had better hair preservation (RR = 2.13; 95%CI = 1.15-3.93; very low certainty).
- The comparison of prolonged with short-duration hypothermia was not statistically significant (RR = 2.06, 95%CI = 0.78-5.39).
- Prolonged scalp hypothermia ranked highest by SUCRA (97.0%); most included studies had high risk of bias.
Why it matters
Chemotherapy-induced hair loss can affect appearance and emotional well-being, and this analysis compares several preventive approaches rather than evaluating scalp cooling alone. Its findings suggest that duration of scalp hypothermia may matter, but the low to very low certainty and high risk of bias mean the comparative ranking should be interpreted cautiously.
What to keep in mind
Most included studies were rated at high risk of bias, and certainty of evidence was low to very low.