脑肿瘤患者神经肿瘤护理中的种族和社会经济差异仍未得到充分探索。本研究旨在分析美国各县级胶质母细胞瘤 (GBM) 护理的差异，重点关注手术的获取以及辅助替莫唑胺化疗和放疗的使用。使用来自监测、流行病学和最终结果的重复横断面数据结果17个数据库；地区卫生资源档案；和美国社区调查，从 2010 年到 2019 年，作者进行了多元回归分析，以了解县级种族和社会经济特征之间的关联，以及手术进行率、手术延迟以及辅助化疗和放疗的使用这项研究总共纳入了十多年来来自美国 602 个不同县的 29,609 名 GBM 患者。 GBM 手术率较低的县与黑人居民比例较高相关（系数 [CE] -0.001，95% CI -0.002 至 0；p < 0.05），并且位于中西部（CE -0.132，95%）相对于东北部，CI -0.195 至 -0.069；p < 0.001）或西部（CE -0.127，95% CI -0.189 至 -0.065；p < 0.001）。延迟手术治疗的县更有可能缺乏神经外科医生（调整后 OR [aOR] 2.52，95% CI 1.77-3.60；p < 0.001），黑人居民比例较高（aOR 1.011，95% CI 1.00-1.02；p < 0.05），并且位于中西部（aOR 3.042，95% CI 1.12-8.24；p < 0.05）或西部（aOR 3.175，95% CI 1.12-8.97 p < 0.05）。辅助放射治疗率较高的县中黑人居民 (aOR 0.987, 95% CI 0.980-0.995; p < 0.01) 和未参保个人 (aOR 0.962, 95% CI 0.937-0.987; p < 0.01) 比例较高的可能性较小）。没有神经外科医生和黑人患者比例较高的县的手术治疗会出现延误，并且 GBM 的手术和辅助治疗的总体比率较低。这项研究强调需要采取有针对性的干预措施和政策，以解决医疗保健获取方面的结构性障碍，改善神经外科劳动力的公平分配，并确保为所有人群提供及时和全面的 GBM 护理。

Racial and socioeconomic disparities in neuro-oncological care for patients with brain tumors remain underexplored. This study aimed to analyze county-level disparities in glioblastoma (GBM) care in the United States, focusing on access to surgery and the use of adjuvant temozolomide chemotherapy and radiation therapy.Using repeated cross-sectional data from the Surveillance, Epidemiology, and End Results 17 database; the Area Health Resources File; and the American Community Survey, from 2010 to 2019, the authors performed multivariate regression analyses to understand the associations between county-level racial and socioeconomic characteristics, as well as the rates of surgery performed, delays in surgery, and use of adjuvant chemotherapy and radiation therapy for newly diagnosed GBM.In total, 29,609 GBM patients from 602 different US counties over a decade were included in this study. Counties with lower rates of surgery for GBM were associated with a higher percentage of Black residents (coefficient [CE] -0.001, 95% CI -0.002 to 0; p < 0.05) and being located in the Midwest (CE -0.132, 95% CI -0.195 to -0.069; p < 0.001) or West (CE -0.127, 95% CI -0.189 to -0.065; p < 0.001) relative to the Northeast. Counties with delayed surgical treatment were more likely to lack neurosurgeons (adjusted OR [aOR] 2.52, 95% CI 1.77-3.60; p < 0.001), have a higher percentage of Black residents (aOR 1.011, 95% CI 1.00-1.02; p < 0.05), and be located in the Midwest (aOR 3.042, 95% CI 1.12-8.24; p < 0.05) or West (aOR 3.175, 95% CI 1.12-8.97 p < 0.05). Counties with high rates of adjuvant radiation therapy were less likely to have higher percentages of Black residents (aOR 0.987, 95% CI 0.980-0.995; p < 0.01) and uninsured individuals (aOR 0.962, 95% CI 0.937-0.987; p < 0.01).Counties without neurosurgeons and those with a higher percentage of Black patients have delays in surgical care and demonstrate lower overall rates of surgery and adjuvant therapy for GBM. This study underscores the need for targeted interventions and policies that address structural barriers in healthcare access, improve equitable distribution of the neurosurgery workforce, and ensure timely and comprehensive GBM care to all populations.