A pilot study to assess the feasibility of prior scalp cooling with palliative whole brain radiotherapy

The objective of this work was to perform a feasibility study on the use of scalp cooling during palliative whole brain radiotherapy. Seven patients (1 male, 6 female) with good performance status underwent scalp cooling prior to and during radiotherapy for cerebral metastases. Five patients were prescribed 12 Gy in two fractions and two patients were prescribed 20 Gy in five fractions. Phantom thermoluminescent dosemeter (TLD) studies to assess the build-up effect from the scalp cap were performed. Seven out of eight patients that were offered scalp cooling completed treatment uneventfully. One patient reported discomfort on application of the scalp cap and continued treatment without scalp cooling. No patients reported other adverse effects from use of the cap during treatment or at follow-up. TLD studies demonstrated a 55-80% increase in dose to the scalp after application of the scalp cap. All patients experienced hair loss. Scalp cooling caps are well tolerated through a course of palliative whole brain radiotherapy. The scalp dose is significantly increased owing to a bolus effect from the scalp cap.