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| 1 | Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors显示文摘AIM:To evaluate systemic treatment choices in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors(PNETs)and provide consensus treatment recommendations.METHODS:Systemic treatment options for pancreatic neuroendocrine tumors have expanded in recent years to include somatostatin analogs,angiogenesis inhibitors,inhibitors of mammalian target of rapamycinand cytotoxic agents.At this time,there is little data to guide treatment selection and sequence.We therefore assembled a panel of expert physicians to evaluate systemic treatment choices and provide consensus treatment recommendations.Treatment appropriateness ratings were collected using the RAND/UCLA modified Delphi process.After studying the literature,a multidisciplinary panel of 10 physicians assessed the appropriateness of various medical treatment scenarios on a 1-9 scale.Ratings were done both before and after an extended discussion of the evidence.Quantitative measurements of agreement were made and consensus statements developed from the second round ratings.RESULTS:Specialties represented were medical and surgical oncology,interventional radiology,and gastroenterology.Panelists had practiced for a mean of15.5 years(range:6-33).Among 202 rated scenarios,disagreement decreased from 13.2%(26 scenarios)before the face-to-face discussion of evidence to 1%(2)after.In the final ratings,46.5%(94 scenarios)were rated inappropriate,21.8%(44)were uncertain,and30.7%(62)were appropriate.Consensus statements from the scenarios included:(1)it is appropriate to use somatostatin analogs as first line therapy in patients with hormonally functional tumors and may be appropriate in patients who are asymptomatic;(2)it is appropriate to use everolimus,sunitinib,or cytotoxic chemotherapy therapy as first line therapy in patients with symptomatic or progressive tumors;and(3)beyond first line,these same agents can be used.In patients with uncontrolled secretory symptoms,octreotide LAR doses can be titrated up to 60 mg every4 wk or up to 40 mg every 3 or 4 wk.CONCLUSION:Using the Delphi process allowed physician experts to systematically obtain a consensus on the appropriateness of a variety of medical therapies in patients with PNETs. | Jonathan R Strosberg George A Fisher Al B Benson Lowell B Anthony Bulent Arslan John F Gibbs Edward Greeno Renuka V Iyer Michelle K Kim William J Maples Philip A Philip Edward M Wolin Dasha Cherepanov Michael S Broder | 2015 | World Journal of Gastroenterology2015，21，8： | 2 |
| 2 | Astrocyte elevated gene-1 regulates hepatocellular carcinoma development and progression显示文摘 | Yoo Byoung Kwon Emdad Luni Su Zao-zhong Villanueva Augusto Chiang Derek Y Mukhopadhyay Nitai D Mills Alan Scott Waxman Samuel Fisher Robert A Llovet Josep M Fisher Paul B Sarkar Devanand | 2009 | Journal of Clinical Investigation2009，，3： | 2 |
| 3 | Direct least square fitting of ellipses显示文摘 | FITZGIBBON A PILU M FISHER R B | 1999 | IEEE Transac tions on Pattern Analysis and Machine Intelli gence1999，21，5： | 1 |
| 4 | Five - year results of a randomized Clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treat ment of breast cancer 显示文摘 | Fisher B Bauer M Margolese R | 1985 | N Engl J med1985，312，11： | 1 |
| 5 | Regulation of mda-7 gene expression during human melanoma differentiation显示文摘 | Madireddi M T Dent P Fisher P B | 2000 | Oncogene2000，19，10： | 1 |
| 6 | Dislocation distributions in brown diamond显示文摘 | WILLEMS B MARTINEAU P M FISHER D | 2006 | Physical Status Solid2006，12，： | 1 |
| 7 | Direct least square fitting of ellipses显示文摘 | Fitzgibbon A Pilu M Fisher R B | 1999 | Pattern Analysis and Machine Intelligence IEEE Transactions on1999，21，： | 1 |
| 8 | Direct least square fitting of ellipses显示文摘 | FITZGIBBON A PILU M FISHER R B | 1999 | IEEE Transactions on Pat- tern Analysis Machine Intelligence1999，21，5： | 1 |
| 9 | Direct least squares fitting of ellipses显示文摘 | Fitzgibbon A W Pilu M Fisher R B | 1999 | IEEE Transactions on Pattern Analysis and Machine Intelligence1999，21，5： | 1 |
| 10 | Application ofphysiologically based pharmacokinetic models in chemical riskassessment显示文摘 | Mumtaz M Fisher J Blount B | 2012 | J Toxicol2012，2012，9： | 1 |
| 11 | Downregulation of the ERK 1 and 2 mitogen activated protein kinases using antisense oligonucleotides inhihits proliferation of porcine vascular smooth muscle cells显示文摘 | Fisher M Liu B Glennon PE | 2001 | Atheroselrosis2001，156，2： | 1 |
| 12 | Gonadotmphin-in- dueed follicle development in red deer hinds during the breeding and non-breeding seasons显示文摘 | MeLeed B J Meikle L M Fisher M W | 2001 | Reproduction2001，122，1： | 1 |
| 13 | Direct least square fitting of ellipses显示文摘 | FLIZGIBBON A PILU M FISHER B | 1999 | IEEE Trans Pattern Anal Mach lntell1999，21，5： | 1 |
| 14 | Gluose update during induced stress is insulin independent and enhanced by adrenergic blockade 显示文摘 | Lekas M Fisher S J Bahrani B | 1999 | J Appl Physiol1999，87，： | 1 |
| 15 | Sedimentary structures in base-surge deposits with special reference to cross-bedding, Ubehebe Craters, Death Valley, California显示文摘 | CROWE B M FISHER R V | 1973 | Geological Society of America Bulletin1973，84，： | 1 |
| 16 | Common Fixed Point Theorems in Complex Valued Metric Spaces 显示文摘 | Azam A Fisher B Khan M | 2011 | Numer Funt Anal Optim2011，32，3： | 1 |
| 17 | Vehicle routing with time windows: two optimization algorithms 显示文摘 | Fisher M Jornsten K O Madsen O B | 1997 | Operations Research1997，，45： | 1 |
| 18 | Glucose uptake during centrally induced stress is insulin independent and enhanced by adrenergic blockade 显示文摘 | LEKAS M FISHER SJ EJ BAHRANI B | 1999 | J Appl Physiol1999，87，： | 1 |
| 19 | Factors associated with pressure ulcers in adults in acute care hospitals显示文摘 | FISHER A R WELLS G HARRISON M B | 2004 | Holist Nurs Pract2004，18，5： | 1 |
| 20 | Experimental Fretting-Wear Studies of Steam Generator Materials显示文摘 | Fisher N J Chow A B Weckwerth M K | 1995 | Journal of Pressure Vessel Technology1995，117，： | 1 |
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