Journal of Clinical Case Reports

Systematic Review of the Risk of Permanent Alopecia with Docetaxel Treatment for Breast Cancer

Abstract

Shirin Nezafat Namini

Aim: The most commonly reported adverse reactions of docetaxel are neutropenia, anaemia, alopecia, nausea, vomiting, stomatitis, diarrhoea and asthenia. Alopecia is a distressing side-effect of cancer treatment and can have a significant negative impact on self-esteem and quality of life. The incidence of permanent alopecia with docetaxel is unclear. We reviewed available evidence relating to permanent alopecia associated with docetaxel given for the treatment of breast cancer. Method: A full literature search was performed using Medline with key words docetaxel and alopecia. Studies were included if they reported the use of docetaxel either alone or in combination regimens in breast cancer and provided information on permanent alopecia. Results: In total three papers were found. Tallon et al. reported a case of permanent alopecia in a 72-year-old caucasian female who was treated with 3 weekly adjuvant carboplatin (AUC6 650 mg), docetaxel (75 mg/m2) and trastuzumab (4 mg/kg) for 6 cycles. This was followed by a year of 3 weekly trastuzumab. After her first cycle carboplatin was removed from the regimen because of severe neutropenia. She experienced scalp hair loss 2 weeks into treatment and this persisted at 13 months after completion of treatment with only minimal re-growth. A punch biopsy showed a reduction in hair follicles. She had no previous history of alopecia but was treated for hypothyroidism.