# QUARTZ: whole-brain radiotherapy versus supportive care alone for brain metastases from non-small-cell lung cancer

Source: https://onco.cc/key-papers/paper-quartz-lancet-2016/  
OnCo record `paper-quartz-lancet-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

For patients with lung cancer brain metastases unsuitable for surgery or radiosurgery, whole-brain radiotherapy added no meaningful survival or quality of life compared with steroids and supportive care alone.

## Summary

Non-inferiority phase 3 trial of 538 patients with brain metastases from non-small-cell lung cancer unsuitable for resection or stereotactic radiotherapy, randomised to optimal supportive care with dexamethasone with or without whole-brain radiotherapy (20 Gy in five fractions).

Quality-adjusted life years were 46.4 days with radiotherapy and 41.7 days without, a difference within the non-inferiority margin, and overall survival was about nine weeks in both arms.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2016
- DOI: 10.1016/S0140-6736(16)30825-X
- Authors: Mulvenna P, Nankivell M, Barton R, et al.
- Findings: Quality-adjusted life years 46.4 vs 41.7 days (non-inferior).; Median overall survival about 9 weeks in both arms.
- What it means: Whole-brain radiotherapy is not a default for poor-prognosis brain metastases; supportive care alone is an acceptable choice, with radiotherapy reserved for selected younger, fitter patients.
- Caveats: Population had a very poor prognosis; subgroups such as those under 60 may benefit.; Predates targeted therapy for driver-mutated lung cancer with brain penetration.

## Sources

- Lancet 2016: https://doi.org/10.1016/S0140-6736(16)30825-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/27604504/

## Connected records

- cancers: [Brain metastases (secondary brain tumours)](https://onco.cc/cancers/secondary-brain-tumours/)
- drugs: [Dexamethasone](https://onco.cc/drugs/dexamethasone/)
- trials: [QUARTZ](https://onco.cc/trials/quartz/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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