Health Inequities within Radiation Treatment after Neurosurgery

Summary: Brain metastases are the most common intracranial tumors, with high recurrence rates post-surgery without adjuvant therapy. Rural patients underutilize adjuvant radiation therapy despite its benefits, contributing to worse outcomes. Our retrospective study at the University of Louisville Health Brown Cancer Center (2018–2023) examined disparities in treatment access and outcomes. We found rural patients were more likely to be uninsured (p = 0.0307) and had higher 1-year post-surgery mortality and brain failure rates (p = 0.0044, p = 0.008). Additionally, only 13.3% of patients attended their scheduled radiation oncology appointment, and none had assigned patient navigators. Our findings highlight the possible advantage for patient navigation programs to improve access to care and reduce disparities among underserved populations in Kentucky.