{"entity":{"id":"paper-quartz-lancet-2016","kind":"paper","name":"QUARTZ: whole-brain radiotherapy versus supportive care alone for brain metastases from non-small-cell lung cancer","aka":[],"tldr":"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).\n\nQuality-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.","asOf":"2026-09-17","links":[{"label":"Lancet 2016","url":"https://doi.org/10.1016/S0140-6736(16)30825-X"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27604504/"}],"tags":[],"related":[],"cancers":["secondary-brain-tumours"],"sections":[],"technologies":[],"targets":[],"drugs":["dexamethasone"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["quartz"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2016,"doi":"10.1016/S0140-6736(16)30825-X","pmid":"27604504","authors":"Mulvenna P, Nankivell M, Barton R, et al.","paperType":"rct","findings":["Quality-adjusted life years 46.4 vs 41.7 days (non-inferior).","Median overall survival about 9 weeks in both arms."],"whatItMeans":"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."],"changedPractice":true,"participants":538},"route":"/key-papers/paper-quartz-lancet-2016/","neighbours":{"cancer":[{"id":"secondary-brain-tumours","kind":"cancer","name":"Brain metastases (secondary brain tumours)","route":"/cancers/secondary-brain-tumours/"}],"drug":[{"id":"dexamethasone","kind":"drug","name":"Dexamethasone","route":"/drugs/dexamethasone/"}],"trial":[{"id":"quartz","kind":"trial","name":"QUARTZ","route":"/trials/quartz/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}