{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:53:45Z","timestamp":1790114025757,"version":"4.0.1"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T00:00:00Z","timestamp":1643068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Linear accelerator (LINAC) and Gamma Knife (GK) are common stereotactic radiation therapies for treating vestibular schwannoma (VS). There is currently limited literature examining specific demographic and socioeconomic factors, which influence the type of stereotactic radiation therapy a patient with VS receives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database was queried for cases of VS between 2004 and 2016. Patient demographic characteristics were compared using chi\u2010squared and <jats:italic>t<\/jats:italic>\u2010tests between GK and LINAC treated groups. Multivariate regression analysis was performed to assess predictors of stereotactic radiation therapy received.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 6,208 included patients, 5,306 (85.5%) received GK and 902 (14.5%) received LINAC. The mean age of GK patients was significantly lower than that of LINAC patients (58.0 vs. 59.7, <jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001). Individuals treated with GK had greater proportions of private insurance (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001) and incomes greater than $63,332 (<jats:italic>P<\/jats:italic>\u00a0=\u2009.003). A greater proportion of GK patients were treated in academic centers (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001), in high\u2010volume facilities (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001), in metropolitan areas (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001), and in the Northeastern United States (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001). On multivariate logistic regression analysis, region, metropolitan area, facility type, tumor size, and distance traveled by patients independently predict receipt of GK versus LINAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Differences in patient demographics and other social determinants of health influence choice of GK versus LINAC therapy for VS patients. Future studies focused on addressing barriers to care, which may influence postprocedural quality of life and clinical outcomes associated with these two treatments are necessary to better understand the impact of these social differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 132:2232\u20132240, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30016","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T12:11:02Z","timestamp":1643112662000},"page":"2232-2240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of Social Determinants of Health on Stereotactic Radiotherapy for Vestibular Schwannoma"],"prefix":"10.1002","volume":"132","author":[{"given":"Amar D.","family":"Desai","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0123-7275","authenticated-orcid":false,"given":"Vraj P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2168-7935","authenticated-orcid":false,"given":"Christopher C.","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-182X","authenticated-orcid":false,"given":"Roman","family":"Povolotskiy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2904-5072","authenticated-orcid":false,"given":"P. 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