Research Article Deterioration of Health-Related Quality of Life Scores under Treatment Predicts Longer Survival Maike Jörling, Sandra Rutzner, Markus Hecht , Rainer Fietkau , and Luitpold V. Distel Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany Correspondence should be addressed to Luitpold V. Distel; luitpold.distel@uk-erlangen.de Received 10 February 2020; Accepted 23 July 2020; Published 17 August 2020 Academic Editor: Noriyoshi Sawabata Copyright © 2020 Maike Jörling et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Baseline health-related quality of life (HRQoL) scores predict survival, which has already been demonstrated in various studies. However, we were interested in whether changes in baseline scores during treatment are also significant predictors of survival. Methods and Materials. We analysed the data of 400 consecutive cancer patients receiving radiochemotherapy. Leading diagnoses were head and neck cancer (34.5%), rectal cancer (24.5%), and lung cancer (13%). HRQoL was studied at baseline, six weeks after therapy and after each completed year after the start of therapy until drop out of the study using the EORTC QLQ- C30 questionnaire. The change score was calculated as the baseline score subtracted from the score after therapy. Statistics included Kaplan-Meier estimates and Cox regression. Results. High global health status (p =0:005) and low pain scores (p =0:040) at baseline were related to favourable overall survival. Change scores of role functioning (p =0:027), global health status ( p <0:018), and pain (p <0:001) were predictive of overall survival. Pain was the superior predictor of survival (p =0:001 ) among all variables and QoL scores studied by multivariate analysis. A deterioration in pain was associated with a 2.8 times higher chance of survival (HR 0.36). Conclusions. Deterioration of HRQoL baseline pain score by cancer treatment is a favourable and superior prognostic factor for survival. 1. Introduction Great scientific progress has been achieved in the fields of medicine, hygiene, and health care in recent decades, result- ing in prolonged survival times for patients [1]. However, the number of cancer patients will further increase due to demographic change [2]. Both aspects together have already resulted in a dramatically increased number of long-term survivors of cancer and it will continue to rise [3, 4]. Another factor influencing this is increasingly specialized therapy options [5, 6]. Statistics from the USA prove that cancer plays an impor- tant role; in 2016, cancer was the second most frequent cause of death in the United States and one in four deaths could be attributed to cancer [7]. Important influencing and risk fac- tors in recent decades such as smoking have also led to cancer cases becoming more frequent and therapy becoming increasingly important. In the last several years, scientists have discovered that successful therapy and survival are closely related to quality of life. Cancer patients experience a wide variety of symptoms and reach their limits when trying to manage them. Their symptoms directly influence their quality of life. Therefore, symptom management improves QoL [8, 9]. Although more research has been done in recent years regarding these topics, this is not yet sufficient. As the number of cancer sur- vivors continues to rise, not only the pure survival time but also the late effects of radiochemotherapy and the health- related quality of life (HRQoL) are crucial for patients. Radiochemotherapy in particular has a major influence on HRQoL [10]. HRQoL is highly relevant for patient care; it directly influences therapy, satisfaction, and compliance. Since patients themselves are the best source for measuring HRQoL, various questionnaires are used in clinical trials worldwide. HRQoL is important for making treatment deci- sions; especially, the questionnaire QLQ-C30 of the EORTC Hindawi BioMed Research International Volume 2020, Article ID 3565238, 10 pages https://doi.org/10.1155/2020/3565238