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Reply to Comments on: “Preventing chemotherapy-induced alopecia: a prospective clinical trial on the efficacy and safety of a scalp cooling system in early breast cancer patients treated with anthracyclines.”

British Journal of Cancer volume 121, page 806 (2019)Cite this article

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We would like to thank you for the interest in our study. The first issue raised by Kako et al. is about the concordance between patients and nurse/physician Dean’s score.

With respect to this issue, we agree that there may be a difference in the subjective assessment of alopecia by patients compared to medical staff. In fact, it is possible that medical staff underestimate the effect of hair loss as it has already been highlighted in the study by Rugo et al. where it was noted that the scores reported by patients are generally lower.1,2 In the Discussion of our paper,3 we pointed out that patients who interrupted the scalp cooling system because of unsatisfactory results were 11%. In addition, only 12 patients answered the question in the EORTC-BR23 questionnaire on being upset for the hair loss, showing an increased distress overtime (p < .01). These numbers are too small to draw definitive conclusions.

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References

  1. Rugo, H. S., Klein, P., Melin, S. A., Hurvitz, S. A., Melisko, M. E., Moore, A. et al. Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer. JAMA 317, 606–614 (2017).

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  2. Rugo, H. S., Serrurier, K. M., Melisko, A., Glencer, A., Hwang, J., D’Agostino, R. et al. Use of the DigniCapTM system to prevent hair loss in women receiving chemotherapy (CTX) for stage I breast cancer (BC). Cancer Res. 72(24 supp.), P2-12-11 (2012).

  3. Munzone, E., Bagnardi, V., Campennì, G., Mazzocco, K., Pagan, E., Tramacere, A. et al. Preventing chemotherapy-induced alopecia: a prospective clinical trial on the efficacy and safety of a scalp-cooling system in early breast cancer patients treated with anthracyclines. Br. J. Cancer https://doi.org/10.1038/s41416-019-0520-8 (2019).

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Author information

Authors and Affiliations

  1. Division of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy

    Elisabetta Munzone

  2. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy

    Eleonora Pagan & Vincenzo Bagnardi

  3. Department of Oncology and Hemato-Oncology University of Milan and Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy

    Ketti Mazzocco

Authors
  1. Elisabetta Munzone
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  2. Eleonora Pagan
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  3. Vincenzo Bagnardi
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  4. Ketti Mazzocco
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Contributions

E.M., E.P., V.B., K.M. made substantial contribution to study design and were all involved in drafting the manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Elisabetta Munzone.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The original study was approved by the local ethic committee (Istituto Europeo di Oncologia, IRCCS). All patients signed written informed consent. The study was performed in accordance with the Declaration of Helsinki.

Funding

None.

Data availability

Data supporting the results reported in the article are available at Clinical Trial Office, European Institute of Oncology, Milan, Italy. Restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of European Institute of Oncology, Milan, Italy.

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Munzone, E., Pagan, E., Bagnardi, V. et al. Reply to Comments on: “Preventing chemotherapy-induced alopecia: a prospective clinical trial on the efficacy and safety of a scalp cooling system in early breast cancer patients treated with anthracyclines.”. Br J Cancer 121, 806 (2019). https://doi.org/10.1038/s41416-019-0577-4

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