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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 | Adverse events of upper GI endoscopy显示文摘 | Tamir Ben-Menachem G. Anton Decker Dayna S. Early Jerry Evans Robert D. Fanelli Deborah A. Fisher Laurel Fisher Norio Fukami Joo Ha Hwang Steven O. Ikenberry Rajeev Jain Terry L. Jue Khalid M. Khan Mary L. Krinsky Phyllis M. Malpas John T. Maple Ravi N. S | 2012 | Gastrointestinal Endoscopy2012，，4： | 2 |
| 3 | An abinitio CFF93 all-atom forcefield for polyearbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | Journal of the American Chemical Society1994，116，7： | 1 |
| 4 | An ab initio CFF93 all-atom force field for polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | J Am Chem Soc1994，116，7： | 1 |
| 5 | Ab initio calculations on small molecule analogs of polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1995 | J Phy Chem1995，99，16： | 1 |
| 6 | The MMPI-2 and vocational assessment : A brief report显示文摘 | Westefeld J S Maples M | 1998 | Career Assessment1998，61，： | 1 |
| 7 | Stathmin 1:a novel therapeutic target for anticancer activity显示文摘 | Rana S Maples PB Senzer N | 2008 | Expert Rev Anticancer Ther2008，8，9： | 1 |
| 8 | Plastid division is mediated by combinatorial assembly of plastid division proteins显示文摘 | Maple J Aldridge C Mqbller S G | 2005 | Plant Journal2005，43，6： | 1 |
| 9 | Lutein and zeaxanthin concentrations in rod outer segment membranes from perifoveal and peripheral human retina 显示文摘 | RAPP L M MAPLE S S CHOI J H | 2000 | Invest Ophthalmol Vis Sci2000，41，5： | 1 |
| 10 | Computational aeroelastic analysis of store-induced limit-cycle oscillation显示文摘 | Parker G H Maple R C Beran P S | 2007 | Journal of Aircraft2007，44，1： | 1 |
| 11 | An ab initio CFFP3 all-atom force field for polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | J Am Chem Soc1994，116，： | 1 |
| 12 | Evaluation of epothilone B analog in advanced soft tissue sarcoma: a phase Ⅱ study of the phaseⅡ consortium显示文摘 | Maples WJ Mahoney MR | 2005 | J Clin Oncol2005，23，13： | 1 |
| 13 | An ab initio CFF93 all-atom force field for polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | Journal of the American Chemical Society1994，116，7： | 1 |
| 14 | Stathmin 1:a novel thempeutic target for anticancer activity显示文摘 | Rana S Maples PB Senzer N | | 0，，09： | 1 |
| 15 | The MMPI-2 and vocational assessment : a brief report显示文摘 | Westefeld John S Michael Maples | 1998 | Journal of Career Assessment1998，6，1： | 1 |
| 16 | Foliar feeding of potassium nitrate in cotton显示文摘 | OOSTERHUIS D M WULLSCHLEGER S D MAPLES R L MILEY W N | 1990 | Better Crops with Plant Food1990，74，： | 1 |
| 17 | Evaluation of epothilone B analog in advanced soft tissue sarcoma: a phase II study of the phase II consortium 显示文摘 | Okuno S Maples WJ Mahoney MR | 2005 | J Clin Oncol2005，23，： | 1 |
| 18 | Developing essential skills through case study scenarios 显示文摘 | Sawyer A J Tomlinson S R Maples A J | 2000 | Journal of Accounting Education2000，18，： | 1 |
| 19 | Improved superconducting properties of MgB2显示文摘 | Li S Maple M B | 2001 | Physica C2001，363，： | 1 |
| 20 | An ab initio cff93 all- atom force field for polycarbonates 显示文摘 | Sun H Mumby S J Maple J R | 1994 | Journal of the AmericanChemical Society1994，116，： | 1 |
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