Department of Neurological Surgery, University of Miami, Miami, Florida, USA.
Department of Neurological Surgery, University of Miami, Miami, Florida, USA.
World Neurosurg. 2024 Jul;187:93-98. doi: 10.1016/j.wneu.2024.04.049. Epub 2024 Apr 16.
Leptomeningeal disease (LMD) is a devastating sequela of many cancers, with an extremely poor prognosis. Barriers to improving outcomes are related to the inability of many traditional therapies to effectively reach the cerebrospinal fluid (CSF) space within the central nervous system. Liquorpheresis is an emerging treatment modality specific to CSF diseases, the primary mechanism of action of which is direct targeted filtration of CSF content by neurosurgical access. In this review, we highlight the principles of liquorpheresis and detail how LMD can be amenable to this treatment. Further, we summarize the current in vitro and in vivo evidence supporting liquorpheresis as a feasible method to treat LMD and other central nervous system diseases as well as describe its conceivable limitations.
脑膜疾病（LMD）是许多癌症的毁灭性后遗症，预后极差。阻碍改善结果的原因与许多传统疗法无法有效到达中枢神经系统内的脑脊液（CSF）空间有关。脑脊液清除术是一种针对 CSF 疾病的新兴治疗方式，其主要作用机制是通过神经外科通路直接靶向 CSF 内容物的过滤。在这篇综述中，我们强调了脑脊液清除术的原则，并详细说明了 LMD 如何适应这种治疗方法。此外，我们总结了目前支持脑脊液清除术作为治疗 LMD 和其他中枢神经系统疾病的可行方法的体外和体内证据，并描述了其可以想象的局限性。
