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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 | What prognostic factors are important in duodenal adenocarcinoma显示文摘 | Faisal G B Michel M M Michael G S | 2000 | Arch Surg2000，135，1： | 1 |
| 3 | Antiproliferative effects of tocopherols (vitamin E) on murine glioma C6 cells:homologue-specific control of PKC/ERK and cyclin signaling显示文摘 | Michele B Andrea M Barbara C | 2006 | Free Radical Biology and Medicine2006，41，： | 1 |
| 4 | The osmotic potential of polyethylene glycol 6000显示文摘 | Michel B E Kaufmann M R | 1973 | Plant Physiol1973，51，： | 1 |
| 5 | The osmotic potential of polyethylene glycol 6000显示文摘 | Michel B E Kaufmann M R | 1973 | Plant Physiology1973，51，5： | 1 |
| 6 | Recurring chromosomal abnormalities in leukemia in PML-RARA transgenic mice parallel human acute promyelocytic leukemia显示文摘 | Michelle M Le B Sheila B | 2002 | Blood2002，99，8： | 1 |
| 7 | Single scattering by red blood cells显示文摘 | Hammer M Schweitzer D Michel B | 1998 | Appl Opt1998，37，： | 1 |
| 8 | 显示文摘 | ALAIN M MICHEL B MICHEL A | 1986 | J Chem Edu1986，63，4： | 1 |
| 9 | The osmotic potential of olyethylene glicol 6000显示文摘 | Michel B E Kaufmann M R | 1973 | Plant Physiology1973，51，5： | 1 |
| 10 | The osmotic potential of polythylene glycol 6000显示文摘 | Michel B E Kaufmann M R | 1973 | Plant Physiology1973，51，5： | 1 |
| 11 | Decomposition of laser altimeter waveforms 显示文摘 | Michelle A H Jean B M Bryan J | 2000 | IEEE Transaction on Geoseienee and Remote Sensing2000，38，4： | 1 |
| 12 | Recommendations for chamber quantification: A report from the american society of echocardiography's guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology显示文摘 | LANG R M MICHELLE BIERIG DEVEREUX R B | 2005 | J Am Soc Echocardiogr2005，18，： | 1 |
| 13 | The osmotic potential of polyethylene glycol 6000显示文摘 | MICHEL B E KAUFMANN M R | 1973 | Plant Physiol1973，51，： | 1 |
| 14 | Cytologic Features of Metastatic Sebaceous Carcinoma: Report of Two Cases With Comparison to Three Cases of Basal Cell Carcinoma显示文摘 | Saha Sadeghi Martha B Pilman Michele M Weir | 1999 | 21(5) :340 -3451999，21，5： | 1 |
| 15 | Mi-croRNA-124 protects against focal cerebral ischemia via mechanisms involving Usp14-dependent REST degradation显示文摘 | Doeppner TR Doehring M Bretschneider E Zechariah A Kaltwasser B Müller B Koch JC B?hr M Hermann DM Michel U | | 0，，： | 1 |
| 16 | Traversing the learning curve in minimally invasive heart valve surgery:a cumulative analysis of an individual surgeon's experience with a right minithoracotomy approach for aortic valve replacement显示文摘 | Michele M Cerillo AG Stefano B | | 0，，： | 1 |
| 17 | The osmotic potential of polyethylene glycol 6000显示文摘 | Michel B E Kaufmann M R | 1973 | Plant Physiol1973，51，： | 1 |
| 18 | 查看详情显示文摘 | Landen O L Boehly T R Bradley D K Braun D G Callahan D A Celliers P M Collins G W Dewald E L Divol L Glenzer S H Hamza A Hicks D G Hoffman N Izumi N Jones O S Kirkwood R K Kyrala G A Michel P Milovich J Munro D H Nikroo A Olson R E Robey H F Spears B K Th | | 0，，： | 1 |
| 19 | 母乳喂养史和子宫内膜异位症发生的风险:前瞻性队列研究显示文摘目的研究经产妇母乳喂养、纯母乳喂养、产后闭经时间与子宫内膜异位症发病率的关系。设计前瞻胜队列研究。 | Leslie V Farland A Heather Eliassen Rulla M Tamimi Donna Spiegelman Karin B Michels Stacey A Missmer 龚丽云 王淑珍 | 2018 | 英国医学杂志中文版2018，21，3： | 1 |
| 20 | 显示文摘 | Suzanne M Michel B Levine A | 2002 | J Clin Endocrinol Metab2002，87，6： | 1 |
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