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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 | Prospective 10-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass显示文摘 | Morris F L Naughton G A Gibbs J L | 1997 | J Bone Miner Res1997，12，9： | 1 |
| 4 | Prospective ten-month exercise intervention in premenarcheal girls:positive effects on bone and lean mass显示文摘 | Morris F L Naughton G A Gibbs J L | 1997 | Journal of bone and mineral research1997，12，9： | 1 |
| 5 | Molecular complexes of nucleosides and nucleotides with a monomeric cationic perphyfin and some of its metal derivatives显示文摘 | PASTERNACK R F GIBBS E J GAUDEMER A | 1985 | J Am Chem Soc1985，107，： | 1 |
| 6 | Streetscale bioretention basins in melbourne and their effect on local biodiversity显示文摘 | Kazemi F Beecham S Gibbs J | 2009 | Ecol Eng2009，35，12： | 1 |
| 7 | The distribution of mineral matter in pulverized coal particles in relation to burnout behaviour 显示文摘 | WIGLEY F WILLIANMSON J GIBB W H | 1997 | Fuel1997，76，： | 1 |
| 8 | 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 |
| 9 | 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 |
| 10 | The Hyper - CVADchemotherapy regimen has an adverse long - term impact on the a- bility to mobilize peripheral blood stem cells, which can be readilycircumvented by using the early cycles for mobilization显示文摘 | KEANE C GIBBS S SEYMOUR J F | 2006 | Hema- tol Oncol2006，24，3： | 1 |
| 11 | Growth of filamentous fungi in submerged culture: Problems and possible solutions显示文摘 | Gibbs P A Seviour R J Schmid F | 2000 | Crit Rev Biotechnol2000，20，： | 1 |
| 12 | Malignant fibrous histiocytoma:an institutional review显示文摘 | Gibbs Huang J F Lee P P | 2001 | Cancer investigation2001，19，1： | 1 |
| 13 | Human skin mast cells rapidly release preformed and newly generated TNF-alpha and IL-8 following with anti-IgE and other secretagogues显示文摘 | Gibbs B F Wiereeky J Welker P | 2001 | Exp Dermatol2001，10，5： | 1 |
| 14 | Interaction of Porphyrins with NucleicAcids显示文摘 | Pastemack R F Gibbs E J Villafranca J J | 1983 | Biochemistry1983，22，： | 1 |
| 15 | A possible paralysis virus of termites显示文摘 | Gibbs A J Gay F J Wetherly A H | 1970 | Virology1970，40，： | 1 |
| 16 | Interactions of porphyrins with nucleic acids 显示文摘 | Pasteranck R F Gibbs E J Villafranca J J | 1983 | Biochemistry1983，22，10： | 1 |
| 17 | Advanced Document Retrieval Techniques for Patent Research显示文摘 | RYLEY F J SAFFER J Gibbs A | 2008 | World Patent Information2008，30，3： | 1 |
| 18 | Effect of molecular structure on burning velocity 显示文摘 | Gibbs G J Calcote H F | 1959 | J Chem Eng Data1959，4，3： | 1 |
| 19 | Streetscale bioretention basins in Melbourne and their effect on local biodiversity显示文摘 | Kazemi F Beecham S Gibbs J | 2009 | Ecol Eng2009，35，12： | 1 |
| 20 | Combined methods of otolith shape Analysis improve identification of spawning areas of Atlantic cod显示文摘 | Galley E A Wright P J Gibb F M | 2006 | ICES Journal of Marine Science2006，63，9： | 1 |
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