Twenty minutes of scalp cooling after a taxane drip, rather than ninety

The trials. In a Dutch multicentre trial of 134 people starting three-weekly docetaxel, 73 per cent with 20 minutes of post-infusion cooling and 79 per cent with 45 minutes needed no head covering (p = 0.5). In a second trial with weekly paclitaxel, hair preservation succeeded in 82 per cent with 20 minutes and 75 per cent with 45 minutes, and the authors concluded that 20 minutes is as effective as 45 and 90 minutes and should be the new standard of care.

Supporting data. The Dutch Scalp Cooling Registry (4680 patients, 68 hospitals) found post-infusion cooling under 85 minutes as effective as longer across the taxane and anthracycline regimens studied. A 2025 review reports that post-cooling times in practice range from 15 minutes to 4 hours, often without evidence for longer durations, and that institutions often rely on manufacturer recommendations because no national or international guideline sets cooling times.

What is not known. How many units use 20 minutes after taxanes has not been measured in any source read. The trials were in Dutch patients, mostly with European hair type, and did not cover antibody-drug conjugates. With anthracyclines, shortening below 90 minutes has not been tested in a randomised trial read here.