AIM: To evaluate the safety and efficacy of scalp cooling in preventing chemotherapy-induced alopecia among Japanese patients with gynecological cancer. METHODS: A retrospective study was conducted involving 16 patients with gynecological cancer who underwent chemotherapy with scalp cooling at our institution between January 2021 and April 2024. The completion rate of the planned regimens, the success rate (defined as hair loss ≤50%), hair volume recovery 8-12 weeks after chemotherapy, and adverse events were assessed. Additionally, patient satisfaction was measured using the net promoter score (NPS) following chemotherapy completion. RESULTS: Of the 16 patients included in the study, chemotherapy regimens comprised six courses of combination therapy with paclitaxel plus carboplatin in 11 cases, three courses of the same regimen in three cases, and three courses of combination therapy with docetaxel plus carboplatin in two cases. The overall completion rate of the planned regimens was 75% (12/16 cases). Among the 12 cases, nine were evaluable for alopecia, with a success rate of 33.3%. The proportion of the patients who recovered hair volume from ≤50% to >
50% was 83.3% in the occipital region. Adverse events were reported as follows: chills in 75.0%, jaw pain in 68.8%, headache in 31.3%, nausea in 18.8%, and hypertension and hunger in 12.5% each. The NPS for scalp cooling was 26.7 points. CONCLUSION: Scalp cooling is effective and safe in preventing hair loss and restoring hair volume in Japanese patients with gynecological cancer, suggesting high patient satisfaction with this treatment.