尽管已经取得了许多进展，H3K27改变的弥漫性中线胶质瘤（DMG），在以前称为位于脑干的弥漫性内皮质胶质瘤，其预后仍然黑暗而令人沮丧。过去十年的大量研究革新了我们对DMG分子基础的理解，揭示了治疗这种致命儿童癌症的潜在可靶向脆弱性。然而，成功临床实施新型疗法的障碍仍然存在，包括有效地穿越血脑屏障（BBB）到达肿瘤部位。在这里，我们审视相关文献和临床试验，并讨论通过增强对流输送（CED）的直接药物输送作为DMG有希望的治疗方式。我们概述了一个全面的分子、药理和程序方法，可能为患者和他们的家人提供希望。在成功地将药物输送到DMG方面仍存在挑战。虽然CED和其他技术提供了绕过BBB的机会，但影响成功肿瘤内靶向的变量是众多复杂的。我们讨论这些变量和可能的解决方案，这些解决方案可以导致预临床有希望的治疗制剂成功地临床实施。

Despite much progress, the prognosis for H3K27-altered diffuse midline glioma (DMG), previously known as diffuse intrinsic pontine glioma when located in the brainstem, remains dark and dismal.A wealth of research over the past decade has revolutionized our understanding of the molecular basis of DMG, revealing potential targetable vulnerabilities for treatment of this lethal childhood cancer. However, obstacles to successful clinical implementation of novel therapies remain, including effective delivery across the blood-brain barrier (BBB) to the tumor site. Here, we review relevant literature and clinical trials and discuss direct drug delivery via convection-enhanced delivery (CED) as a promising treatment modality for DMG. We outline a comprehensive molecular, pharmacological, and procedural approach that may offer hope for afflicted patients and their families.Challenges remain in successful drug delivery to DMG. While CED and other techniques offer a chance to bypass the BBB, the variables influencing successful intratumoral targeting are numerous and complex. We discuss these variables and potential solutions that could lead to the successful clinical implementation of preclinically promising therapeutic agents.