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Baker et al. J Cancer Metastasis Treat 2020;6:24 Journal of Cancer
DOI: 10.20517/2394-4722.2020.36 Metastasis and Treatment

Original Article Open Access

Burden of chronic diseases among sarcoma
survivors treated with anthracycline chemotherapy:

results from an observational study

Laurence H. Baker , Philip S. Boonstra , Denise K. Reinke , Erin J. Peregrine Antalis , Bradley J. Zebrack ,
1
2
1
3
1
Richard L. Weinberg 4
1 Department Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
2 Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA.
3 School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
4 Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
Correspondence to: Dr. Laurence H. Baker, Department Internal Medicine, University of Michigan Medical School, 3A17 NIB,
300 North Ingalls St., Ann Arbor, MI 48109, USA. E-mail: bakerl@med.umich.edu

How to cite this article: Baker LH, Boonstra PS, Reinke DK, Peregrine Antalis EJ, Zebrack BJ, Weinberg RL. Burden of chronic
diseases among sarcoma survivors treated with anthracycline chemotherapy: results from an observational study. J Cancer
Metastasis Treat 2020;6:24. http://dx.doi.org/10.20517/2394-4722.2020.36

Received: 21 Apr 2020 First Decision: 5 Jun 2020 Revised: 12 Jun 2020 Accepted: 8 Jul 2020 Published: 7 Aug 2020
Academic Editor: Ian Judson Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Cardiovascular disease is a leading cause of mortality among long-term cancer survivors treated with large
total doses of doxorubicin. An increase in coronary artery disease (CAD) among childhood cancer survivors by age
45 has been observed and is driven by primarily anthracycline chemotherapy and to a lesser extent chest radiation
that includes the heart in the radiation field. The risk factors and associated chronic diseases (hypertension, etc.)
are well known for CAD and can be often prevented or treated, thus reducing the risk of CAD in these patients. We
piloted a risk-based survivorship clinic in an academic medical center to characterize the distribution of risk factors
for CAD and improve the quality of life in a population of sarcoma survivors treated with doxorubicin.

Methods: We followed a prospective cohort of sixty-one survivors of bone and soft tissue sarcoma treated with
2
doxorubicin chemotherapy (> 400 mg/m ) and at least 2 years post-therapy attending the sarcoma survivorship
clinic. We collected clinical, demographic data, and patient reported outcomes via PROMIS questionnaires
annually.

Results: We demonstrated a high burden of chronic diseases in this population. Among six chronic conditions
that are known risk factors for CAD (hypertension, diabetes, obesity, chronic inflammation, kidney disease and

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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