Title : Scalp cooling intervention in patients receiving nab paclitaxel, cisplatin and gemcitabine for pancreatic cancer
Abstract:
Background: It is estimated that 64,050 new cases of pancreatic cancer will be diagnosed in the US in 2023. Alopecia can be a distressing and unwanted symptom experienced by patients with pancreatic cancer receiving nab-paclitaxel based regimens.
Objective: To determine if patients with pancreatic cancer experience hair preservation using the Paxman scalp cooling device while receiving nab-paclitaxel, cisplatin, and gemcitabine. Additional objectives sought to understand the level of reported comfort during scalp cooling in addition to level of distress related to chemotherapy-induced alopecia.
Methods: This study was a feasibility study using a one arm, repeated measures pilot design. Hair loss in each patient was determined from baseline, by an independent observer, with the goal of hair preservation. Comfort level of the patient while receiving scalp cooling and distress related to chemotherapy-induced alopecia were assessed.
Results: Of the eligible nineteen patients, nine patients participated in the study, resulting in a 45% patient declination response rate. Five patients completed all three, three-week cycles of chemotherapy representing six scalp cooling treatments. Of the five patients who completed all expected cooling treatments, 40% (n=2) ended the study with grade 1 alopecia and 60% (n=3) ended with grade 2 alopecia.
Conclusions: Efficacy of this device could not be determined due to the small sample size. 45% of eligible patients declined to participate as we found patients to be worried about treatment decisions versus alopecia. While prevention of alopecia is not critical to all patients with pancreatic cancer who are receiving treatment known to cause alopecia, it is important to some.
Audience take away notes:
- A nurse-led intervention can provide patients with the opportunity to participate in and potentially benefit from supportive care research trials.
- Resources should be directed to facilitate opportunities to design and implement professional nurse-led supportive care research to advance health outcomes and care satisfaction.
- Research that does not meet the expected objectives continues to contribute to the body of knowledge, allowing for care advancement opportunities.
- In the case of this study, addressing the feelings of overwhelm and decision burden within the study design is important.
- A nurse-led research study requires foundational support and resources to meet design outcomes such as patient enrollment and access to innovative supportive care interventions.
- Across all spectrums of healthcare, but especially in clinical research, it important for the nurse to understand how best to support patients as they are making decisions related to clinical treatment, potential benefit, and the addition of possible supportive care studies.
- There is importance in conducting supportive care studies in a space where interventional drug clinical trials are also conducted.
- This study was conducted in a research institute where patients are provided with clinical trial options for treatment of their pancreatic cancer.
- These options may have lessened the patients interest in a supportive care trial such as scalp cooling, as patients were focused on making timely decisions related to their treatment options.
