Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, 1400 Holcombe, Unit 431, Houston, TX 77030, USA.
Neurosurg Clin N Am. 2011 Jan;22(1):67-78, vii. doi: 10.1016/j.nec.2010.08.006.
Leptomeningeal metastasis (LMD) is a lethal complication caused by a variety of cancers, typically developing late in the disease course. It is associated with major neurologic disabilities and short survival. The incidence of LMD may increase because of longer survival of patients who have cancer, and because of the use of newer large-molecule therapies with poor central nervous system penetration. To achieve improved outcomes for patients who have LMD, new treatments need to reach the meninges and cerebrospinal fluid and interact with relevant molecular targets. Some of the agents currently in testing may contribute to this goal. To allow for better outcomes through earlier treatment, advances in diagnosis are needed. By using agents with higher therapeutic indices, in patients with a lower burden of disease (identified earlier with clinical or molecular markers) it should be possible to achieve gradual improvements in outcomes for patients suffering from this devastating disease.
脑膜转移（LMD）是由多种癌症引起的致命并发症，通常在疾病晚期发生。它与严重的神经残疾和短期生存有关。由于癌症患者的生存时间延长，以及使用穿透中枢神经系统能力较差的新型大分子治疗药物，LMD 的发病率可能会增加。为了改善脑膜转移患者的预后，需要新的治疗方法到达脑膜和脑脊液，并与相关的分子靶点相互作用。一些正在测试中的药物可能有助于实现这一目标。为了通过早期治疗获得更好的结果，需要在诊断方面取得进展。通过使用治疗指数更高的药物，在疾病负担较低的患者中（通过临床或分子标志物更早地识别），有可能逐渐改善患有这种毁灭性疾病的患者的预后。
