软脑膜疾病（LMD）是指癌细胞浸润到软脑膜室。软脑膜是两层膜，称为蛛网膜和软脑膜。 LMD 的弥漫性对其有效诊断和成功管理提出了挑战。此外，主要的表型；固体物质或自由漂浮的细胞，对药物输送系统的有效性具有不同的影响。标准治疗是鞘内输送化疗药物，但它会增加治疗相关并发症、患者依从性低和药物分布不理想。另一种方法是全身给药，然后药物必须穿过液体屏障到达软脑膜间隙内的目的地。然而，已知该途径会引起脱靶效应，并在中枢神经系统内的靶位点产生亚治疗药物浓度。脂质体阿糖胞苷等新型药物递送系统的开发改善了软脑膜转移性疾病的药物递送，但仍需要做很多工作才能有效地针对这种具有挑战性的疾病。在这篇综述中，我们讨论了与药物渗透相关的软脑膜的解剖结构、LMD 的传统和先进的药物输送方法。我们还讨论了不同临床试验设定的未来方向。

Leptomeningeal disease (LMD) refers to the infiltration of cancer cells into the leptomeningeal compartment. Leptomeninges are the two membranous layers, called the arachnoid membrane and pia mater. The diffuse nature of LMD poses a challenge to its effective diagnosis and successful management. Furthermore, the predominant phenotype; solid masses or freely floating cells, has altering implications on the effectiveness of drug delivery systems. The standard of care is the intrathecal delivery of chemotherapy drugs but it is associated with increased instances of treatment-related complications, low patient compliance, and suboptimal drug distribution. An alternative involves administering the drugs systemically, after which they must traverse fluid barriers to arrive at their destination within the leptomeningeal space. However, this route is known to cause off-target effects as well as produce subtherapeutic drug concentrations at the target site within the central nervous system. The development of new drug delivery systems such as liposomal cytarabine has improved drug delivery in leptomeningeal metastatic disease, but much still needs to be done to effectively target this challenging condition. In this review, we discuss about the anatomy of leptomeninges relevant for drug penetration, the conventional and advanced drug delivery methods for LMD. We also discuss the future directions being set by different clinical trials.