Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

The objective of this study was to characterize pRIA in patients with primary central nervous system (CNS)tumors or head and neck sarcoma.DESIGN, SETTING, AND PARTICIPANTS. A retrospective cohort study of patients from January 1,2011, to January 30, 2019, was conducted at 2 large tertiary care hospitals and comprehensive cancer centers. Seventy-one children and adults diagnosed with primary CNS tumors or head and neck sarcomas were evaluated for pRIA.

MAIN OUTCOMES AND MEASURES

The clinical and trichoscopic features, scalp radiation dose-response relationship, and response to topical minoxidil were assessed using standardized clinical photographs of the scalp, trichoscopic images, and radiotherapy treatment plans.

RESULTS

Of the 71 patients included (median [range] age, 27 [4-75] years; 51 female [72%]),64 (90%) had a CNS tumor and 7 (10%) had head and neck sarcoma. Alopecia severity was grade 1 in 40 of 70 patients (56%), with localized (29 of 54 [54%]), diffuse (13 of 54 [24%]),or mixed (12 of 54 [22%]) patterns. The median (range) estimated scalp radiation dose was 39.6 (15.1-50.0) Gy; higher dose (odds ratio [OR], 1.15; 95% CI, 1.04-1.28) and protonirradiation (OR, 5.7; 95% CI, 1.05-30.8) were associated with greater alopecia severity (P< .001), and the dose at which 50% of patients were estimated to have severe (grade 2) alopecia was 36.1 Gy (95% CI, 33.7-39.6 Gy). Predominant trichoscopic features included white patches (16 of 28 [57%]); in 15 patients, hair-shaft caliber negatively correlated with scalp dose (correlation coefficient, −0.624;P= .01). The association between hair density and scalp radiation dose was not statistically significant (−0.381;P= .16). Twenty-eight of 34 patients (82%) responded to topical minoxidil, 5% (median follow-up, 61 [interquartile range,21-105] weeks); 4 of 25 (16%) topical minoxidil recipients with clinical images improved in severity grade. Two patients responded to hair transplantation and 1 patient responded to plastic surgical reconstruction.

CONCLUSIONS AND RELEVANCE

Persistent radiation-induced alopecia among patients with primary CNS tumors or head and neck sarcomas represents a dose-dependent phenomenon that has distinctive clinical and trichoscopic features. The findings of this study suggest that topical minoxidil and procedural interventions may have benefit in the treatment of pRIA

Book a Consult

Please enable JavaScript in your browser to complete this form.

Our Procedures

Hair Transplants Platelet Rich Plasma Therapy (PRP)
This Is the Best Medical Center!
“Dr. Unger is a wonderful hair transplant specialist. I would recommend to anyone in need.”
J.S.
Read More Testimonials

Contact Us

Please enable JavaScript in your browser to complete this form.

Visit Our Office

If you would like to speak with Dr. Unger or Dr. Williams, or request an appointment, please fill out the contact form. You can expect a response from a staff member within 1-2 business days.

710 Park Avenue, Suite 1A New York NY, 10021

New Patients:
(212) 249-4369

At Unger Medical, we strive to provide the highest quality care to all our patients. Please note that we do not accept insurance. We understand this may be an inconvenience, and we are committed to offering transparent and competitive pricing for our services. For any questions or to discuss payment options, please feel free to contact our office. We appreciate your understanding and look forward to working with you.