【摘要】 脑膜转移是晚期肺癌、乳腺癌等实体瘤的严重并发症，由于血脑屏障的存在，系统性治疗效果有限，患者预后极差。鞘内注射作为局部治疗的核心手段，能规避血脑屏障限制，将药物直接递送至蛛网膜下腔，从而提高中枢神经系统内的药物浓度，并减少全身性毒性反应。除甲氨蝶呤、阿糖胞苷等传统化疗药物外，培美曲塞等新型化疗药物、部分靶向药物及免疫检查点抑制剂也逐渐被探索用于鞘内治疗，并在部分患者中显示出良好的疗效与安全性。但现有证据多基于小样本研究，其疗效与安全性仍需更多前瞻性研究进一步验证。本文围绕鞘内注射在非小细胞肺癌脑膜转移治疗中的作用机制、常用药物、临床研究进展及疗效评价进行综述，以期为该治疗的规范应用与未来研究方向提供参考。更多还原

【Abstract】 Leptomeningeal metastasis is a severe complication of advanced cancers such as lung and breast cancer. Due to the blood-brain barrier, systemic treatments are often ineffective, leading to poor prognosis. Intrathecal injection, as a local treatment method, bypasses the blood-brain barrier by delivering drugs directly to the subarachnoid space, thus increasing drug concentration in the central nervous system and reducing systemic toxicity. In addition to traditional chemotherapy drugs like methotrexate and cytarabine, newer agents such as pemetrexed, targeted therapies, and immune checkpoint inhibitors are being explored for intrathecal therapy, showing promising efficacy and safety in some patients. However, existing evidence is mainly based on small sample studies, and further prospective research is needed to validate their effectiveness and safety. This review aims to summarize the mechanisms, commonly used drugs, clinical advances, and efficacy of intrathecal injection in the treatment of leptomeningeal metastasis in non-small cell lung cancer.更多还原