Takeaway
- Patients who have received radiation to the scalp for central nervous system (CNS) or head and neck tumors are likely to experience dose-dependent persistent alopecia.
- Treatment with topical minoxidil may improve hair loss in a vast majority of such patients.
Why this matters
- Around 60% of patients with CNS tumors and 30% with head and neck cancer receive radiation to the head.
Study design
- The study included 71 children and adults with persistent hair loss following radiotherapy for primary CNS tumors (n=64) or head and neck sarcoma (n=7).
- Funding: National Institutes of Health/National Cancer Institute Cancer Center.
Key results
- The odds of grade 2 hair loss increased by 15% for every 1 unit increase in radiation dose (OR, 1.15; P<.001>
- Proton irradiation was associated with significantly higher odds of severe hair loss (OR, 5.7; P<.001>
- The majority of patients (82%) treated with topical minoxidil showed a response during a median follow-up of 61 weeks.
- Among patients for whom clinical images were available, 16% showed complete response.
- 2 patients showed improvement with hair transplant, and 1 showed complete response with hair reconstruction.
Limitations
- Retrospective design.
- Lack of complete data for standardized clinical photos, trichoscopy images, and radiotherapy treatment plans.
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