Summary of best evidence for prevention and management of chemotherapy-induced alopecia

Objective To evaluate and summarize the best evidence for prevention and management of chemotherapy-induced alopecia and to provide a reference for clinical practice. Methods In February 2018, literatures including Evidence-based guidelines, best practices, systematic reviews, original research (including randomized controlled trials, quasi-experimental studies and cohort studies) and expert consensus were retrieved from guideline websites such as National Guideline Clearinghouse (NCC) , Scottish Intercollegiate Guidelines Network (SIGN) , National Institute for Health and Clinical Excellence (NICE) , New Zealand Guidelines Group (NZGG) , Registered Nurses Association of Ontario (RNAO) and Medline, professional websites such as American Society of Clinical Oncology (ASCO) , National Comprehensive Cancer Network (NCCN) , American Association for Cancer Research (AACR) , Oncology Nursing Society (ONS) , European Society of Clinical Oncology (ESMO) and Clinical Oncology Society of Australian (COSA) as well as databases such as Australian JBI Evidence-based Healthcare Database, Cochrane Library, PubMed, CINAHL, EMBASE, CNKI and Wanfang Datebase. Two researchers evaluated the quality of various literatures, and extracted recommendations and research conclusions related to the prevention and management of chemotherapy-induced alopecia from the included literatures. Results Totally 13 literatures were included, including 3 evidence-based guidelines, 1 recommended practice, 3 expert consensus, 4 systematic reviews, and 2 original studies. A total of 32 evidences in 2 aspects on the prevention and management of chemotherapy-induced alopecia were summarized. Conclusions The evidence for scalp cooling is sufficient in the prevention of chemotherapy-induced alopecia, but higher quality evidence is still needed for preventive medication and alopecia management. Key words: Antineoplastic combined chemotherapy protocols; Chemotherapy; Alopecia; Prevention; Management; Evidence summary; Scalp cooling