中国肺癌杂志2026，Vol.29Issue(1)：1-14,14.DOI:10.3779/j.issn.1009-3419.2025.102.39
驱动基因阳性非小细胞肺癌脑膜转移临床诊疗中国专家共识(2026版)
Chinese Expert Consensus on Clinical Management of Oncogene Addicted Non-small Cell Lung Cancer with Leptomeningeal Metastasis(2026 Edition)
中国医药教育协会肺癌医学教育专业委员会 1北京医学奖励基金会肺癌医学青年专家委员会转移性肺癌协作组 1支修益 1王洁 1赵军 1杨明 1陈麦林1
作者信息
摘要
Abstract
The prognosis for non-small cell lung cancer(NSCLC)with leptomeningeal metastasis(LM)is ex-tremely poor.However,in oncogene addicted patients,the emergence of targeted therapies with high central nervous system(CNS)penetration is significantly reshaping the treatment landscape.Existing guidelines,which often favor conservative strate-gies,are no longer sufficient to meet the demands of precision medicine.To address this challenge,the Metastasis Lung Cancer Collaboration Group,Youth Specialists Committee of Beijing Medical Reward Foundation convened multidisciplinary experts from Medical Oncology,Radiology,Pathology,Radiotherapy,and Neurosurgery.Based on evidence-based medicine from the past decade and clinical practice experience,they have developed the Chinese expert consensus on clinical management of oncogene addicted NSCLC with leptomeningeal metastasis(2026 edition).This consensus emphasizes that the diagnosis of LM should be based on a comprehensive assessment of clinical symptoms,magnetic resonance imaging(MRI),and cerebrospinal fluid(CSF)cytology.It also highlights the critical role of CSF molecular liquid biopsy in clarifying driver gene status and assessing treat-ment efficacy.In terms of treatment,this consensus advocates for a fundamental paradigm shift:therapy should be led by a mul-tidisciplinary team(MDT),with high-CNS-penetration targeted therapies as the first-line intervention,while local treatments(such as intrathecal injection and radiotherapy)are positioned as supplementary measures.The consensus provides a series of expert recommendations on key aspects,including the selection of high-CNS-penetration tyrosine kinase inhibitors(TKIs),the application of intrathecal chemotherapy,the timing of radiotherapy,and palliative surgery.It aims to establish proactive,individualized treatment standards for patients with NSCLC LM in China,based on molecular subtyping and MDT collabora-tion,thereby improving patient survival outcomes.关键词
肺肿瘤/脑膜转移/驱动基因/靶向治疗/临床诊疗指南Key words
Lung neoplasms/Leptomeningeal metastasis/Actionable gene alterations/Targeted therapy/Clinical practice guidelines引用本文复制引用
中国医药教育协会肺癌医学教育专业委员会,北京医学奖励基金会肺癌医学青年专家委员会转移性肺癌协作组,支修益,王洁,赵军,杨明,陈麦林..驱动基因阳性非小细胞肺癌脑膜转移临床诊疗中国专家共识(2026版)[J].中国肺癌杂志,2026,29(1):1-14,14.
