{"entity":{"id":"idea-mach-cooling-off-the-chair","kind":"idea","name":"Finish scalp cooling away from the infusion chair","aka":[],"tldr":"Scalp cooling keeps patients in the chemotherapy chair for up to two hours longer, which limits how many people a unit can treat. Shorter cooling after the drip and portable coolers could free the chair without losing hair protection.","summary":"A 2025 review of scalp cooling reports post-infusion times from 15 minutes to 4 hours, names chair time and equipment as barriers, and notes that cooling stations outside the infusion chair have been proposed. A randomised trial with weekly paclitaxel found 20 minutes as effective as 45 and 90 minutes, and the Dutch registry of 4,680 patients found no added benefit beyond about 85 minutes. A portable cooler is FDA-cleared for home use (Amma, K211526), and a cost model of a cordless cap assumed it frees the chair. The proposal is to adopt evidence-based shorter post-infusion times by regimen and to move the remainder of cooling to a lounge or home where a portable device allows.","asOf":"2026-11-04","links":[{"label":"Kaufman et al., duration of scalp cooling and how it fits the infusion day: a review (Support Care Cancer 2025)","url":"https://doi.org/10.1007/s00520-025-10058-y"},{"label":"Lugtenberg et al., 20 versus 45 minutes of post-infusion scalp cooling with weekly paclitaxel, randomised trial (Support Care Cancer 2022)","url":"https://doi.org/10.1007/s00520-022-07090-7"},{"label":"Breed et al., post-infusion cooling time in 4,680 patients, Dutch Scalp Cooling Registry (Support Care Cancer 2025)","url":"https://doi.org/10.1007/s00520-025-09526-2"},{"label":"FDA 510(k) K211526: portable scalp cooling system, home use","url":"https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K211526"},{"label":"Ouyang et al., cost-effectiveness of a cordless scalp-cooling cap (Clinicoecon Outcomes Res 2026)","url":"https://doi.org/10.2147/ceor.s574046"}],"tags":["machines-wave3","proposal"],"related":["idea-moon-hair-preservation-for-all"],"cancers":[],"sections":["supportive-care"],"technologies":["scalp-cooling","oncology-infusion-chairs","manual-cold-caps"],"targets":[],"drugs":["paclitaxel"],"companies":["paxman","dignitana","cooler-heads-care"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-workforce"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo machines inventory (openFDA, accessdata.fda.gov, ClinicalTrials.gov v2, Europe PMC, maker pages)","editedOn":"2026-11-04"},"hypothesis":"Regimen-specific shorter post-infusion cooling, finished off the chair where possible, cuts chair time per cooled patient by more than half without a loss in hair preservation.","rationale":"The capacity cost of scalp cooling is chair time, and the trials and registry already show most of the post-infusion period is not needed for taxanes.","test":"A stepped-wedge rollout across infusion units, measuring chair minutes per cooled visit and hair preservation by regimen against the registry baseline.","maturity":"early-clinical","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-mach-cooling-off-the-chair/","neighbours":{"idea":[{"id":"idea-moon-hair-preservation-for-all","kind":"idea","name":"Fund scalp cooling and hair-preserving measures for every alopecia-inducing regimen","route":"/ideas/idea-moon-hair-preservation-for-all/"}],"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"manual-cold-caps","kind":"technology","name":"Manual cold caps (Penguin and other frozen-gel caps)","route":"/technologies/manual-cold-caps/"},{"id":"oncology-infusion-chairs","kind":"technology","name":"Oncology infusion and treatment chairs","route":"/technologies/oncology-infusion-chairs/"},{"id":"scalp-cooling","kind":"technology","name":"Scalp cooling (cold caps: DigniCap, Paxman)","route":"/technologies/scalp-cooling/"}],"drug":[{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"company":[{"id":"cooler-heads-care","kind":"company","name":"Cooler Heads Care","route":"/companies/cooler-heads-care/"},{"id":"dignitana","kind":"company","name":"Dignitana","route":"/companies/dignitana/"},{"id":"paxman","kind":"company","name":"Paxman","route":"/companies/paxman/"}],"bottleneck":[{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"roadmap":[{"id":"chemo-chair-comfort-devices-roadmap","kind":"roadmap","name":"Comfort devices at the chemotherapy chair: scalp cooling, cold caps, limb cryocompression and infusion chairs","route":"/roadmaps/chemo-chair-comfort-devices-roadmap/"}]}}