<![CDATA[Chemotherapy significantly improves the prognosis of breast cancer patients. However, its most disturbing side effect is alopecia, which significantly reduces patients' quality of life. Scalp cooling (SC) was developed to minimize hair loss during chemotherapy. Study objective: To analyze the effectiveness, success factors, technical parameters, and tolerability of SC in breast cancer patients. Study methods: A literature review using the PRISMA approach, including English and Indonesian studies from 2021 to 2026. Keyword combinations: "scalp cooling" and "chemotherapy-induced alopecia" were used to search the literature through PubMed, Scopus, Google Scholar, and DOAJ. Of the 1,744 articles identified, ten articles met the inclusion criteria and underwent further analysis. Results: Scalp cooling was 40%-90% effective in preventing hair loss. It was most effective with taxane-based regimens compared to anthracycline-based regimens. The effectiveness of SC was influenced by the type, dose, and duration of chemotherapy, as well as the cooling temperature. Hair characteristics had no effect. SC contributed to hair recovery and reduced alopecia. It was well tolerated, with mild side effects. However, treatment discontinuation rates were observed in some studies. Conclusion: SC is an effective and evidence-supported supportive intervention to reduce the severity of chemotherapy-induced alopecia in breast cancer survivors. Its success depends on the regimen and requires optimization of technical parameters and patient education to improve its sustainability in clinical practice.]]>
