Background: Chemotherapy (Ctx)-induced alopecia (CIA), produces a deep emotional impact in many female cancer patients (pts). Sensor-controlled scalp cooling (SCSC) has been found to be effective in preventing CIA, However, this technique is infrequently used in many countries due to concerns regarding both safety and feasibility. This prospective non-interventional study was initiated to gain detailed information about the effectiveness and reasons of discontinuation of SCSC using the Paxman system (Paxman, Huddersfield, UK) in German women exposed to CIA-inducing Ctx due to breast cancer (BC) or genital tract malignancies. Methods: 72 pts were included: BC, 54; epithelial ovarian carcinoma, 14; others, 4; premenopausal, 38; postmenopausal, 34. 51 pts were treated in a curative intent, 21 were treated in a palliative setting; 49 pts were Ctx-naïve, 23 pts had a history of prior Ctx. The following Ctx regimens were used: anthracycline-based (A), n = 4; taxane-based (T), n = 18; AT-based, n = 39; non-AT-based, n = 11. Pts were subjected to SCSC during each Ctx cycle. CIA was quantified according to the Dean score (DS) determined 3 wks after the end of Ctx. The primary endpoint was feasibility indicated by the treatment completion rate. Secondary endpoints were the degree of hair preservation (success: DS 0-2, failure: DS 3-4, or discontinuation of SCSC), and safety. Results: 46 pts (63.9%) completed SCSC, with 38 (52.8%) experiencing complete hair preservation (DS 0), and 8 (11.1%) showing partial success (DS 1-2). 26 pts (36.1%) discontinued CTCS, with CIA being the main reason in 18 pts (25%). Headache was reported in 4 (5.6%), and discomfort in 2 pts (2.8%). In the remaining 2 pts (2.8%), the reason for discontinuation was unclear. Side effects were not severe and resolved completely after cessation of SCSC. Conclusions: CTCS using the Paxman system is feasible, safe and effective in order to prevent CIA in pts with BC and female genital tract carcinomas in the clinical routine. Our study is in good agreement with previous reports on CTCS although including a higher proportion of pts in the palliative setting or with a history of prior Ctx.