妊娠滋养细胞肿瘤（GTN）是一组罕见的恶性胎盘相关肿瘤，需要全身抗癌治疗。与GTN相关的蛛网膜下腔疾病（LMD）报道不多，没有关于最佳治疗方案的共识。我们提出了这些患者的治疗建议。我们讨论了五名GTN患者，他们表现出LMD的特征，并通过锗增强的MRI脑部诊断，所有患者都接受了低剂量诱导紫杉醇-顺铂（EP）治疗，然后是EP-紫杉醇，甲氨蝶呤（CNS）和放线菌素D（EMA）或EMA（CNS）-环磷酰胺和长春花碱（CO）。其中四位患者额外接受了腰穿注射甲氨蝶呤。四名患者对第一线多药联合化疗完全hCG响应良好，其中一名患者需要第二线紫杉醇，顺铂交替紫杉醇，紫杉醇被nab-紫杉醇替代，因为患者患有过敏症，接着进行了子宫切除术。最初完全hCG响应者中的一位在肺部复发，需要进一步进行全身治疗，并随后行肺叶切除术。患者报告的结果表明，持续神经症状较轻，不影响功能和生活质量。经过2-6年的随访，所有五名患者均痊愈，避免了对所有病例采用全脑放疗的优异生存结果。版权所有 ©2023年，由Elsevier Inc.发表。

Gestational Trophoblastic Neoplasia (GTN) is a rare group of malignant placental-related tumours requiring systemic anti-cancer treatment. Leptomeningeal disease (LMD) related to GTN is not well reported with no consensus in optimal treatment. We offer recommendations for management of these patients.We discuss five patients with GTN who presented with features of LMD and were diagnosed with gadolinium-enhanced MRI brain, all of whom received low dose induction etoposide-cisplatin (EP) followed by either EP-etoposide, methotrexate (CNS) and actinomycin-D (EMA) or EMA(CNS)-cyclophosphamide and vincristine (CO).Four out of the five patients additionally received intrathecal methotrexate. Four patients had complete hCG response to first line multi-agent chemotherapy, one patient required second line paclitaxel, cisplatin alternating with paclitaxel, etoposide (TP/TE), where paclitaxel was substituted with nab-paclitaxel due to anaphylaxis, followed by hysterectomy. One of the four initial complete hCG responders relapsed in the lung requiring further systemic treatment with subsequent lobectomy. Patient reported outcomes indicate persistent neurological symptoms are mild and do not affect functionality and quality of life.With a follow-up range of 2-6 years, all five patients remain cured demonstrating excellent survival outcomes with the avoidance of whole-brain radiotherapy in all cases.Copyright © 2023. Published by Elsevier Inc.