目前尚无有效的工具可用于对软脑膜转移 (LM) 患者进行临床神经学评估。然而，疾病过程中的临床检查指导医疗管理，也是临床试验中反应评估的一部分。由于临床快速恶化，可能并不总是能够获得神经影像，因此 LM 的临床神经学评估至关重要，标准化对于最大限度地减少评估者的分歧也很重要。RANO-LM 小组启动了一个两步流程，旨在改进和标准化临床评估LM 患者。我们在此报告第一步：建立共识记分卡。该工作组举行了 9 次虚拟会议，确定了神经系统评估的一般建议以及应测试的选定感兴趣领域。选择了 14 个神经系统症状和体征领域：意识水平、认知、恶心和呕吐、视力、眼球运动、面部力量、听力、吞咽、言语、肢体力量、肢体共济失调、行走、膀胱肠功能。对于每个项目，都提供了如何进行评估的明确说明，评分标准介于 0 到 2 之间。应记录患者的一般临床状况以及类固醇、止痛药和止吐药的使用情况。先前脑转移或癌症治疗造成的神经系统后遗症应在基线评估时进行评级；当症状或体征可能与 LM 以外的病症相关时，应予以明确。用于临床评估的修订版 NANO-LM 共识记分卡已经建立。该提案的一项国际前瞻性验证研究目前正在进行中 (NCT06417710)。© 作者 2024。由牛津大学出版社代表神经肿瘤学会出版。

There are no validated tools for the clinical neurological assessment of patients with leptomeningeal metastases (LM). However, clinical examination during the course of the disease guides medical management and is part of response assessment in clinical trials. Because neuroimaging may not always be obtained owing to rapid clinical deterioration, clinical neurological assessment of LM is essential, and standardization Is important to minimize rater disagreement.The RANO-LM group launched a 2-steps process, aiming at improving and standardizing the clinical assessment of patients with LM. We report here on the first step: the establishment of a consensus scorecard. The task force had 9 virtual meetings to define general recommendations on neurological assessment and selected domains of interest that should be tested.Fourteen domains of neurological symptoms and signs were selected: level of consciousness, cognition, nausea and vomiting, vision, eye movement, facial strength, hearing, swallowing, speech, limb strength, limb ataxia, walking, bladder bowel functions. For each item, a clear instruction on how to perform the assessment is provided with scoring criteria between 0 and 2. The general clinical status of the patient and use of steroids, pain medications, and anti-emetics should be documented. Neurological sequelae from previous brain metastases or cancer treatment should be rated at the baseline evaluation; it should be specified when symptoms or signs may be related to a condition other than LM.A revised NANO-LM consensus scorecard for clinical assessment has been established. An international prospective validation study of the proposal is currently ongoing (NCT06417710).© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.