{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:45:56Z","timestamp":1786981556162,"version":"build-2736575974"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"American Society of Clinical Oncology Conquer Cancer Merit Award"},{"DOI":"10.13039\/100014549","name":"Stanford Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014549","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stanford Cancer Institute Women\u2019s Cancer Center Innovation Award"},{"DOI":"10.13039\/100000892","name":"Prostate Cancer Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000892","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Cancer Institute","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]},{"name":"American Society of Clinical Oncology Dr. Judith and Alan Kaur Endowed Young Investigator Award"},{"name":"Stanford Cancer Institute Fellowship Award"},{"name":"Stanford Cancer Institute Justice, Equity, Diversity, and Inclusion Pilot Grant Award"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Stereotactic radiosurgery (SRS) offers less neurotoxicity and comparable survival to whole-brain radiation therapy (WBRT) for brain metastases (BM). Current SRS practice patterns are understudied. We examined national trends in SRS and WBRT utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We queried the National Cancer Database for patients with BM from twelve cancers (\u2265\u200918 years; diagnosed 2004\u20132020) treated with radiotherapy. Patients were grouped by first-course radiotherapy modality (SRS:1\u20135 fractions; WBRT:5\u201315 fractions). Multivariable logistic regression assessed SRS predictors, adjusting for sociodemographic and clinical variables. A race*diagnosis year interaction evaluated temporal trends. Difference-in-differences analysis assessed Medicaid expansion impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 89,984 patients, 24,174 (27%) received SRS. SRS utilization rose from 8 to 54% between 2004 and 2020 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). SRS was more likely in patients diagnosed in recent years (aOR\u2009=\u20093.85 [95% CI\u2009=\u20093.70\u20134.01]), who received prior chemotherapy (aOR\u2009=\u20091.17 [1.13\u20131.21]) or surgery (aOR\u2009=\u20092.25 [2.11\u20132.40]), and those with colorectal (aOR\u2009=\u20091.93 [1.64\u20132.26]), lung (aOR\u2009=\u20091.37 [1.24\u20131.50]), melanoma (aOR\u2009=\u20092.76 [2.46\u20133.10]), thyroid (aOR\u2009=\u20092.17 [1.36\u20133.46]), or kidney\/bladder cancer (aOR\u2009=\u20092.76 [2.44\u20133.12]) versus breast cancer. SRS was less likely in patients with lower income (aOR\u2009=\u20090.88 [0.85\u20130.92]) or educational attainment (aOR\u2009=\u20090.88 [0.85\u20130.92]), Medicaid\/Medicare (aOR\u2009=\u20090.86 [0.83\u20130.90]), no insurance (aOR\u2009=\u20090.49 [0.44\u20130.53]), or treatment at community (aOR\u2009=\u20090.31 [0.29\u20130.34]), comprehensive community (aOR\u2009=\u20090.56 [0.54\u20130.58]), or integrated facilities (aOR\u2009=\u20090.77 [0.73\u20130.80]). Race and ethnicity were not overall associated with SRS use. Medicaid expansion had no impact (aOR\u2009=\u20090.99 [0.88\u20131.10]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SRS utilization increased between 2004 and 2020. However, disparities persist for patients with lower socioeconomic status, uninsured\/public insurance, or non-academic center treatment, potentially reflecting access disparities or differences in disease burden. Targeted efforts are needed to ensure equitable access to advanced cancer therapies, particularly in the context of potential additive effects of disparities in disease burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-025-05178-8","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T06:57:45Z","timestamp":1755845865000},"page":"1211-1225","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stereotactic radiosurgery for brain metastases: evolving practice patterns from the national cancer database (2004\u20132020)"],"prefix":"10.1007","volume":"175","author":[{"given":"Jonathan J.","family":"Shih","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhav","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urvish","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiko","family":"Chino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manali I.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Christopher","family":"Dee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erqi","family":"Pollom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kekoa","family":"Taparra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"issue":"1","key":"5178_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s43856-024-00445-7","volume":"4","author":"JA Miccio","year":"2024","unstructured":"Miccio JA, Tian Z, Mahase SS, Lin C, Choi S, Zacharia BE, Sheehan JP, Brown PD, Trifiletti DM, Palmer JD, Wang M, Zaorsky NG (2024) Estimating the risk of brain metastasis for patients newly diagnosed with cancer. Commun Med 4(1):27. https:\/\/doi.org\/10.1038\/s43856-024-00445-7","journal-title":"Commun Med"},{"issue":"10","key":"5178_CR2","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1007\/s00415-002-0870-6","volume":"249","author":"R Soffietti","year":"2002","unstructured":"Soffietti R, Rud\u0101 R, Mutani R (2002) Management of brain metastases. J Neurol 249(10):1357\u20131369. https:\/\/doi.org\/10.1007\/s00415-002-0870-6","journal-title":"J Neurol"},{"issue":"5","key":"5178_CR3","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1093\/neuonc\/nox195","volume":"20","author":"C Wilke","year":"2018","unstructured":"Wilke C, Grosshans D, Duman J, Brown P, Li J (2018) Radiation-induced cognitive toxicity: pathophysiology and interventions to reduce toxicity in adults. Neuro-Oncol 20(5):597\u2013607 PMID:29045710","journal-title":"Neuro-Oncol"},{"issue":"4","key":"5178_CR4","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.otc.2009.04.003","volume":"42","author":"JM Lasak","year":"2009","unstructured":"Lasak JM, Gorecki JP (2009) The history of stereotactic radiosurgery and radiotherapy. Otolaryngol Clin North Am 42(4):593\u2013599. https:\/\/doi.org\/10.1016\/j.otc.2009.04.003","journal-title":"Otolaryngol Clin North Am"},{"issue":"2","key":"5178_CR5","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/S0360-3016(99)00507-6","volume":"47","author":"E Shaw","year":"2000","unstructured":"Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, Farnan N (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90\u201305. Int J Radiat Oncol 47(2):291\u2013298. https:\/\/doi.org\/10.1016\/S0360-3016(99)00507-6","journal-title":"Int J Radiat Oncol"},{"issue":"4","key":"5178_CR6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1001\/jama.2016.9839","volume":"316","author":"PD Brown","year":"2016","unstructured":"Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, Carrero XW, Barker FG, Deming R, Burri SH, M\u00e9nard C, Chung C, Stieber VW, Pollock BE, Galanis E, Buckner JC, Asher AL (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: A randomized clinical trial. JAMA 316(4):401\u2013409 PMID:27458945","journal-title":"JAMA"},{"issue":"12","key":"5178_CR7","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.6004\/jnccn.2017.7003","volume":"15","author":"BH Kann","year":"2017","unstructured":"Kann BH, Park HS, Johnson SB, Chiang VL, Yu JB (2017) Radiosurgery for brain metastases: changing practice patterns and disparities in the united States. J Natl Compr Cancer Netw JNCCN 15(12):1494\u20131502 PMID:29223987","journal-title":"J Natl Compr Cancer Netw JNCCN"},{"issue":"1","key":"5178_CR8","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s10585-019-10005-2","volume":"37","author":"MS Ascha","year":"2020","unstructured":"Ascha MS, Funk K, Sloan AE, Kruchko C, Barnholtz-Sloan JS (2020) Disparities in the use of stereotactic radiosurgery for the treatment of lung cancer brain metastases: a SEER-Medicare study. Clin Exp Metastasis 37(1):85\u201393 PMID:31705229","journal-title":"Clin Exp Metastasis"},{"issue":"6","key":"5178_CR9","doi-asserted-by":"publisher","first-page":"3764","DOI":"10.21037\/jtd-20-3199","volume":"13","author":"Y Lin","year":"2021","unstructured":"Lin Y, Mak KS (2021) Racial and socioeconomic disparities in the use of stereotactic body radiotherapy for treating non-small cell lung cancer: a narrative review. J Thorac Dis 13(6):3764\u20133771. https:\/\/doi.org\/10.21037\/jtd-20-3199","journal-title":"J Thorac Dis"},{"issue":"2","key":"5178_CR10","first-page":"e4031","volume":"11","author":"A Modh","year":"2019","unstructured":"Modh A, Doshi A, Burmeister C, Elshaikh MA, Lee I, Shah M (2019) Disparities in the use of Single-fraction stereotactic radiosurgery for the treatment of brain metastases from Non-small cell lung Cancer. Cureus 11(2):e4031 PMID:31011494","journal-title":"Cureus"},{"key":"5178_CR11","doi-asserted-by":"publisher","unstructured":"Huang AE, Shih JJ, Sunwoo JB, Pollom E, Taparra K (2024) Racial Disparities in 30-day Readmissions after Surgery for Head and Neck Cancer. Laryngoscope 134(3):1282\u20131287. https:\/\/doi.org\/10.1002\/lary.30997. Epub 2023 Aug 23. PMID: 37610178","DOI":"10.1002\/lary.30997"},{"key":"5178_CR12","doi-asserted-by":"publisher","unstructured":"Taparra K, Benavente R, Shih JJ, Gimmen MY, Tominez P, Kekumano KE, Pineda E, Halualani G, Cakobau H, Ludmir EB, Deville C Jr, Peppercorn J, Gomez SL, Bosserman L, Chino F, Patel MI, Shah C (2024) Race and Ethnicity Representation in Phase 2\/3 Oncology Clinical Trial Publications: A Systematic Review. JAMA Health Forum 7;5(6):e241388. doi: https:\/\/doi.org\/10.1001\/jamahealthforum.2024.1388. Erratum in: JAMA Health Forum. 2024 Jul 5;5(7):e242301. https:\/\/doi.org\/10.1001\/jamahealthforum.2024.2301. PMID: 38848090; PMCID: PMC11161837","DOI":"10.1001\/jamahealthforum.2024.1388"},{"issue":"8","key":"5178_CR13","doi-asserted-by":"publisher","first-page":"e1255","DOI":"10.1200\/OP.22.00001","volume":"18","author":"K Taparra","year":"2022","unstructured":"Taparra K, Dee EC, Dao D, Patel R, Santos P, Chino F (2022) Disaggregation of Asian American and Pacific Islander women with stage 0-II breast Cancer unmasks disparities in survival and Surgery-to-Radiation intervals: A National Cancer database analysis from 2004 to 2017. JCO Oncol Pract 18(8):e1255\u2013e1264. https:\/\/doi.org\/10.1200\/OP.22.00001","journal-title":"JCO Oncol Pract"},{"key":"5178_CR14","unstructured":"Health Affairs. Affordable Care Act (2024); Available from: https:\/\/www.healthaffairs.org\/topic\/4#:~:text=ThepurposeoftheACA,curbrisinghealthcarecosts"},{"key":"5178_CR15","unstructured":"American College of Surgeons ACS (2022) National Cancer database participant user file. American College of Surgeons"},{"issue":"4","key":"5178_CR16","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.nec.2020.06.001","volume":"31","author":"P Sacks","year":"2020","unstructured":"Sacks P, Rahman M (2020) Epidemiology of brain metastases. Neurosurg Clin N Am 31(4):481\u2013488. https:\/\/doi.org\/10.1016\/j.nec.2020.06.001","journal-title":"Neurosurg Clin N Am"},{"key":"5178_CR17","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central Nervous System Cancers (2025); Available from: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1425 [accessed Jul 18, 2025]"},{"issue":"1","key":"5178_CR18","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.ijrobp.2017.12.006","volume":"101","author":"F Chino","year":"2018","unstructured":"Chino F, Suneja G, Moss H, Zafar SY, Havrilesky L, Chino J (2018) Health care disparities in Cancer patients receiving radiation: changes in insurance status after medicaid expansion under the affordable care act. Int J Radiat Oncol Biol Phys 101(1):9\u201320 PMID:29398128","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"5178_CR19","unstructured":"Mitchell A Overview of the ACA Medicaid Expansion. Congressional Research Service; 2021 Jun. Report No.: IF10399. Available from: https:\/\/www.congress.gov\/crs-product\/IF10399"},{"key":"5178_CR20","unstructured":"RStudio. Boston MA (2018) RStudio, PBC"},{"key":"5178_CR21","unstructured":"Nabors LB, Portnow J (2024) Central Nervous System Cancers, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw.;22(2D). Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/cns.pdf [accessed Dec 17, 2024]"},{"issue":"11","key":"5178_CR22","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1016\/S1470-2045(09)70263-3","volume":"10","author":"EL Chang","year":"2009","unstructured":"Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, Arbuckle RB, Swint JM, Shiu AS, Maor MH, Meyers CA (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037\u20131044 PMID:19801201","journal-title":"Lancet Oncol"},{"issue":"4","key":"5178_CR23","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/S1470-2045(14)70061-0","volume":"15","author":"M Yamamoto","year":"2014","unstructured":"Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J, Yamanaka K, Sato Y, Jokura H, Yomo S, Nagano O, Kenai H, Moriki A, Suzuki S, Kida Y, Iwai Y, Hayashi M, Onishi H, Gondo M, Sato M, Akimitsu T, Kubo K, Kikuchi Y, Shibasaki T, Goto T, Takanashi M, Mori Y, Takakura K, Saeki N, Kunieda E, Aoyama H, Momoshima S, Tsuchiya K (2014) Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol 15(4):387\u2013395. https:\/\/doi.org\/10.1016\/S1470-2045(14)70061-0","journal-title":"Lancet Oncol"},{"key":"5178_CR24","doi-asserted-by":"publisher","unstructured":"Mangesius J, Seppi T, Bates K, Arnold CR, Minasch D, Mangesius S, Kerschbaumer J, Lukas P, Ganswindt U, Nevinny-Stickel M (2021) Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival. Sci Rep Springer Sci Bus Media LLC 11(1). https:\/\/doi.org\/10.1038\/s41598-021-88070-5","DOI":"10.1038\/s41598-021-88070-5"},{"key":"5178_CR25","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/1748-717X-9-105","volume":"9","author":"LH Sch\u00fcttrumpf","year":"2014","unstructured":"Sch\u00fcttrumpf LH, Niyazi M, Nachbichler SB, Manapov F, Jansen N, Siefert A, Belka C (2014) Prognostic factors for survival and radiation necrosis after stereotactic radiosurgery alone or in combination with whole brain radiation therapy for 1\u20133 cerebral metastases. Radiat Oncol Lond Engl 9:105 PMID:24885624","journal-title":"Radiat Oncol Lond Engl"},{"issue":"2","key":"5178_CR26","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.ijrobp.2016.06.009","volume":"96","author":"DM Trifiletti","year":"2016","unstructured":"Trifiletti DM, Lee C-C, Kano H, Cohen J, Janopaul-Naylor J, Alonso-Basanta M, Lee JYK, Simonova G, Liscak R, Wolf A, Kvint S, Grills IS, Johnson M, Liu K-D, Lin C-J, Mathieu D, H\u00e9roux F, Silva D, Sharma M, Cifarelli CP, Watson CN, Hack JD, Golfinos JG, Kondziolka D, Barnett G, Lunsford LD, Sheehan JP (2016) Stereotactic radiosurgery for brainstem metastases: an international cooperative study to define response and toxicity. Int J Radiat Oncol Biol Phys 96(2):280\u2013288 PMID:27478166","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"11","key":"5178_CR27","doi-asserted-by":"publisher","first-page":"e41827","DOI":"10.1097\/md.0000000000041827","volume":"104","author":"G-H Lee","year":"2025","unstructured":"Lee G-H, Seol YM, Choi YJ, Kim H (2025) Prognostic factors of brain metastasis and subsequent survival in breast cancer patients: an 11-year, single-center, retrospective study. Medicine (Baltimore) Ovid technologies. (Wolters Kluwer Health) 104(11):e41827. https:\/\/doi.org\/10.1097\/md.0000000000041827","journal-title":"(Wolters Kluwer Health)"},{"key":"5178_CR28","doi-asserted-by":"publisher","unstructured":"Shahi S, Meza J, Tandra P, LeVan T, Bagenda DS, Farazi PA (2022) Gender Differences in Recommended Treatment Decisions among Breast Cancer Patients: A Study Using the National Cancer Database. Clin Breast Cancer 22(4):e444\u2013e456. https:\/\/doi.org\/10.1016\/j.clbc.2021.11.001. Epub 2021 Nov 8. PMID: 34949552","DOI":"10.1016\/j.clbc.2021.11.001"},{"key":"5178_CR29","unstructured":"National Institutes of Health, National Cancer Institute. PAR-17-095: Cancer Center Support Grants (CCSGs) for NCI-designated Cancer Centers (P30). National Institutes of Health (2016) Dec Available from: https:\/\/grants.nih.gov\/grants\/guide\/pa-files\/PAR-17-095.html [accessed Feb 10, 2025]"},{"issue":"1","key":"5178_CR30","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1245\/s10434-009-0771-3","volume":"17","author":"DP Winchester","year":"2010","unstructured":"Winchester DP, Stewart AK, Phillips JL, Ward EE (2010) The National Cancer data base: past, present, and future. Ann Surg Oncol 17(1):4\u20137. https:\/\/doi.org\/10.1245\/s10434-009-0771-3","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"5178_CR31","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.jocn.2014.08.012","volume":"22","author":"JP Caruso","year":"2015","unstructured":"Caruso JP, Moosa S, Fezeu F, Ramesh A, Sheehan JP (2015) A cost comparative study of gamma knife radiosurgery versus open surgery for intracranial pathology. J Clin Neurosci 22(1):184\u2013188. https:\/\/doi.org\/10.1016\/j.jocn.2014.08.012","journal-title":"J Clin Neurosci"},{"issue":"5","key":"5178_CR32","doi-asserted-by":"publisher","first-page":"101438","DOI":"10.1016\/j.adro.2024.101438","volume":"9","author":"J Crooks","year":"2024","unstructured":"Crooks J, Dominic O, Shepard M, Yu A, Liang Y, Karlovits SM, Wegner RE (2024) Cost of treatment for brain metastases using data from a National health insurance provider. Adv Radiat Oncol 9(5):101438. https:\/\/doi.org\/10.1016\/j.adro.2024.101438","journal-title":"Adv Radiat Oncol"},{"key":"5178_CR33","doi-asserted-by":"publisher","first-page":"100292","DOI":"10.1016\/j.jcpo.2021.100292","volume":"29","author":"NH Nathan","year":"2021","unstructured":"Nathan NH, Bakhsheshian J, Ding L, Mack WJ, Attenello FJ (2021) Evaluating medicaid expansion benefits for patients with cancer: National Cancer database analysis and systematic review. J Cancer Policy 29:100292 PMID:35559947","journal-title":"J Cancer Policy"},{"key":"5178_CR34","doi-asserted-by":"publisher","unstructured":"Pasetsky J, Bhatt K, Kachnic LA, Yu JB, Horowitz DP (2024) Inappropriate denials for radiation therapy in medicare advantage plans. Int J Radiat Oncol S0360301624036435. https:\/\/doi.org\/10.1016\/j.ijrobp.2024.11.063","DOI":"10.1016\/j.ijrobp.2024.11.063"},{"key":"5178_CR35","doi-asserted-by":"publisher","first-page":"893264","DOI":"10.3389\/fonc.2022.893264","volume":"12","author":"EJ Lehrer","year":"2022","unstructured":"Lehrer EJ, Jones BM, Dickstein DR, Green S, Germano IM, Palmer JD, Laack N, Brown PD, Gondi V, Wefel JS, Sheehan JP, Trifiletti DM (2022) The cognitive effects of radiotherapy for brain metastases. Front Oncol 12:893264. https:\/\/doi.org\/10.3389\/fonc.2022.893264","journal-title":"Front Oncol"},{"issue":"2","key":"5178_CR36","doi-asserted-by":"publisher","first-page":"e109","DOI":"10.1016\/j.ijrobp.2012.08.007","volume":"85","author":"LM Halasz","year":"2013","unstructured":"Halasz LM, Weeks JC, Neville BA, Taback N, Punglia RS (2013) Use of stereotactic radiosurgery for brain metastases from non-small cell lung cancer in the united States. Int J Radiat Oncol Biol Phys 85(2):e109\u2013116 PMID:23058058","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"5178_CR37","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.semradonc.2016.11.001","volume":"27","author":"M Abdel-Wahab","year":"2017","unstructured":"Abdel-Wahab M, Zubizarreta E, Polo A, Meghzifene A (2017) Improving quality and access to radiation Therapy-An IAEA perspective. Semin Radiat Oncol 27(2):109\u2013117 PMID:28325236","journal-title":"Semin Radiat Oncol"},{"issue":"6","key":"5178_CR38","doi-asserted-by":"publisher","first-page":"542","DOI":"10.3322\/caac.21732","volume":"72","author":"J Zhao","year":"2022","unstructured":"Zhao J, Han X, Nogueira L, Fedewa SA, Jemal A, Halpern MT, Yabroff KR (2022) Health insurance status and cancer stage at diagnosis and survival in the united States. CA Cancer J Clin 72(6):542\u2013560. https:\/\/doi.org\/10.3322\/caac.21732","journal-title":"CA Cancer J Clin"},{"issue":"8","key":"5178_CR39","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/archotol.133.8.784","volume":"133","author":"AY Chen","year":"2007","unstructured":"Chen AY, Schrag NM, Halpern M, Stewart A, Ward EM (2007) Health insurance and stage at diagnosis of laryngeal cancer: does insurance type predict stage at diagnosis? Arch Otolaryngol Head Neck Surg 133(8):784\u2013790 PMID:17709617","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"2","key":"5178_CR40","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1002\/cncr.22788","volume":"110","author":"AY Chen","year":"2007","unstructured":"Chen AY, Schrag NM, Halpern MT, Ward EM (2007) The impact of health insurance status on stage at diagnosis of oropharyngeal cancer. Cancer 110(2):395\u2013402 PMID:17562558","journal-title":"Cancer"},{"issue":"3","key":"5178_CR41","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/S1470-2045(08)70032-9","volume":"9","author":"MT Halpern","year":"2008","unstructured":"Halpern MT, Ward EM, Pavluck AL, Schrag NM, Bian J, Chen AY (2008) Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis. Lancet Oncol 9(3):222\u2013231 PMID:18282806","journal-title":"Lancet Oncol"},{"issue":"20","key":"5178_CR42","doi-asserted-by":"publisher","first-page":"3127","DOI":"10.1002\/cncr.30159","volume":"122","author":"SC Markt","year":"2016","unstructured":"Markt SC, Lago-Hernandez CA, Miller RE, Mahal BA, Bernard B, Albiges L, Frazier LA, Beard CJ, Wright AA, Sweeney CJ (2016) Insurance status and disparities in disease presentation, treatment, and outcomes for men with germ cell tumors. Cancer 122(20):3127\u20133135 PMID:27500561","journal-title":"Cancer"},{"issue":"4","key":"5178_CR43","first-page":"417","volume":"20","author":"LX Clegg","year":"2009","unstructured":"Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, Goodman MT, Lynch CF, Schwartz SM, Chen VW, Bernstein L, Gomez SL, Graff JJ, Lin CC, Johnson NJ, Edwards BK (2009) Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National longitudinal mortality study. Cancer Causes Control CCC 20(4):417\u2013435 PMID:19002764","journal-title":"Cancer Causes Control CCC"},{"key":"5178_CR44","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.wneu.2019.04.031","volume":"130","author":"SC Pannullo","year":"2019","unstructured":"Pannullo SC, Julie DAR, Chidambaram S, Balogun OD, Formenti SC, Apuzzo MLJ, Knisely JPS (2019) Worldwide access to stereotactic radiosurgery. World Neurosurg 130:608\u2013614 PMID:31581410","journal-title":"World Neurosurg"},{"issue":"18","key":"5178_CR45","first-page":"3278","volume":"128","author":"EC Dee","year":"2022","unstructured":"Dee EC, Pierce LJ, Winkfield KM, Lam MB (2022) Pursuit of equity in cancer care: moving beyond the affordable. Care Act Cancer 128(18):3278\u20133283 PMID:35818772","journal-title":"Care Act Cancer"},{"key":"5178_CR46","unstructured":"American Society for Radiation Oncology. Bipartisan bill to modernize radiation oncology reimbursement introduced in Congress, American Society for Radiation Oncology (2024) May Available from: https:\/\/www.astro.org\/news-and-publications\/news-and-media-center\/news-releases\/2024\/bipartisan-bill-to-modernize-radiation-oncology-reimbursement-introduced-in-congress [accessed Jan 3, 2025]"},{"issue":"4","key":"5178_CR47","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.prro.2022.02.003","volume":"12","author":"V Gondi","year":"2022","unstructured":"Gondi V, Bauman G, Bradfield L, Burri SH, Cabrera AR, Cunningham DA, Eaton BR, Hattangadi-Gluth JA, Kim MM, Kotecha R, Kraemer L, Li J, Nagpal S, Rusthoven CG, Suh JH, Tom\u00e9 WA, Wang TJC, Zimmer AS, Ziu M, Brown PD (2022) Radiation therapy for brain metastases: an ASTRO clinical practice guideline. Pract Radiat Oncol 12(4):265\u2013282. https:\/\/doi.org\/10.1016\/j.prro.2022.02.003","journal-title":"Pract Radiat Oncol"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-025-05178-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-025-05178-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-025-05178-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T11:38:51Z","timestamp":1781609931000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11060-025-05178-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":47,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["5178"],"URL":"https:\/\/doi.org\/10.1007\/s11060-025-05178-8","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]},"assertion":[{"value":"3 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was reviewed and approved as exempt from full review by the Stanford University Institutional Review Board because de-identified and publicly available data in the NCDB do not constitute human subjects research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors affirm that this study was reviewed and approved as exempt from informed consent to participate because data were deidentified.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that this study was reviewed and approved as exempt from informed consent to published because data were deidentified.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}}]}}