ArticleJournal of neuro-oncology2026
Evaluation of disparities in timely stereotactic radiosurgery for brain metastases in a safety net hospital system through a centralized workflow.
Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
9 authors.
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Abstract
purposeThe diagnosis and treatment of brain metastases (BMs) pose significant challenges to patients, their caregivers, and physicians. Stereotactic radiosurgery (SRS) is a primary or adjuvant approach for the treatment of BMs but underlying socioeconomic factors may delay access to SRS and subsequent follow-up care.
methodsThis is a retrospective study of patients with brain metastases who underwent Gamma Knife® (GK) SRS as their primary treatment modality from 2012 to 2023 at a multi-hospital health system with a safety net hospital through a centralized workflow for referrals. Time from first BM diagnosis to initial SRS was analyzed across patient demographics, median household income based on U.S. Census Bureau 5-year estimates, insurance carrier, and public versus private referring hospital. Survival analyses were conducted using the Kaplan-Meier method.
results1216 patients with 4576 brain metastases were included in the analysis. The median time from diagnosis of BM to SRS was 15 days. Patients referred from the public hospital had increased time to SRS (25 days) compared to the private hospital (14 days, p < 0.001) and were more likely to be lost to follow-up (21% vs. 5%, p < 0.001). There was no difference in overall survival between any groups for patients that received SRS.
conclusionSystemic institutional and socioeconomic barriers affect timely SRS delivery following newly diagnosed BMs. Through a centralized workflow in in coordinating complex oncologic care in a multi-hospital network, increased time to receive SRS did not translate into measurable survival disparities.
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