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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 | Genetic analysis of four porcine avian influenza viruses isolated from Shandong 显示文摘 | Shi W F Gibbs M J Zhang Y Z | 2008 | China Arch Virol2008，153，： | 1 |
| 3 | Unravelling the pathophysi ology of complex regional pain syndrome:focus on sympathetically main- tained pain显示文摘 | Gibbs G F Drummond P D Finch P M | 2008 | Clin Exp Pharmacol Physiol2008，35，7： | 1 |
| 4 | Power law relationships between bond length, bond strength and electron density distributions 显示文摘 | Gibbs G V Hill F C Boisen M B | 1998 | Phys Chem Miner1998，25，： | 1 |
| 5 | A physical basis for Pauling's definition of bond strength 显示文摘 | Gibbs G V Rosso K M Cox D F | 2003 | Phys Chem Miner2003，30，： | 1 |
| 6 | Bioturbators enhance ecosystem function through complex biogeochemical interactions显示文摘 | Lohrer A M Thrush S F Gibbs M M | 1997 | Nature1997，，： | 1 |
| 7 | Evidence that a plant virus switched hosts to infect a vertebrate and then recombined with a vertebrate-infecting virus显示文摘 | Gibbs M J Weiller G F | 1999 | Proc Natl Acad Sci USA1999，96，14： | 1 |
| 8 | Cellular heterogeneity in DNA damage and growth inhibition induced by ICI D1694, thymidylate synthase inhibitor, using single cell assays 显示文摘 | Schtiber C Gibbs J F Yin M B etal | 1994 | Biochemical Pharmacology1994，48，5： | 1 |
| 9 | Patterns of Nd and Sr isotopic ratios produced by magmatic and post-magnetic processes in the Shiant Isles Main Sill, Scotland 显示文摘 | Foland K A Gibb F G F Henderson C M B | 2000 | Contributions to Mineralogy and Petrology2000，139，： | 1 |
| 10 | Thermal inactivation of Alicngclobacillus acidoterrestris spores under different temperature, soluble solids and pH conditions for the design of fruit processes 显示文摘 | SILVA F M GIBBS P VIEIRAC M C | 1999 | International Journal of Food Microbiology1999，51，1： | 1 |
| 11 | Chemistry of the Shiant Isles Main Sill, NW Scotland, and wider implications for the petrogenesis of mafic sills 显示文摘 | Gibb F G F Henderson C M B | 2006 | Journal of Petrology2006，47，： | 1 |
| 12 | Predicting injection site muscle damage m evaluation of intramuscular formulations in the L6 cell model 显示文摘 | EVANS L A F GENEREUX P E GIBBS E M | 1996 | Pharm Res1996，13，10： | 1 |
| 13 | The fate of ground- water ammonium in a lake edge wetland显示文摘 | Lusby F Gibbs M Cooper A | 1998 | Journal of En- vironment Quality1998，27，： | 1 |
| 14 | Regulation of cytochrome P450 by posttranslational modification显示文摘 | Aguiar M Masse R Gibbs B F | 2005 | Drug Metabolism Reviews2005，37，2： | 1 |
| 15 | Target selection in designing pasteurization processes for shelf-stable high-acid fruit products 显示文摘 | Silva F V M Gibbs P | 2004 | CriticalReviews in Food Science and Nutrition2004，44，5： | 1 |
| 16 | Bioleaehing of heavy metals from a low grade mining ore using Aspergillus niger 显示文摘 | Mulligan C N KamLi M Gibbs B F | 2004 | J Hazard Mater2004，110，： | 1 |
| 17 | Influence of operating parameters on NOx and N2O axial profiles in a circulating fluidized bed combustor显示文摘 | de DIEGO L F LONDONO C A WANG X S GIBBS B M | 1996 | Fuel1996，75，8： | 1 |
| 18 | Synthetic nano-LDL with paclitaxel oleate as a targeted drug delivery vehicle for glioblastoma muhiforme显示文摘 | Nikanjam M Gibbs A R Hunt C A Budinger T F Forte T M | 2007 | J Contr ReI2007，124，： | 1 |
| 19 | Bioleaching of heavy metals from a low-grade mining ore using AspergiUus niger显示文摘 | Mulligan C N Kamali M Gibbs B F | 2004 | Jttazar Mater2004，110，： | 1 |
| 20 | Usability and Impact of Digital Libraries : A Review 显示文摘 | Chowdhury S Landoni M Gibb F | 2006 | Online Information Review2006，30，6： | 1 |
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