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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 | Medical-grade silicone induces release of proinflammatory cytokines in peripheral blood mononuclear cells without activating T cells显示文摘 | FRANCESC M M MATHILDE H RENUKA K P | 2009 | Inc J Biomed Mater Res:B2009，90，2： | 1 |
| 3 | To Measure of not to Measure Total Factor Productivity Growth显示文摘 | Renuka M | 2003 | Oxford Develooment Studies2003，，31： | 1 |
| 4 | Energy consumption, economic growth and prices: Areassessment using panel VECM for developed and devel- oping countries显示文摘 | Renuka M John A A | 2007 | Energy Policy2007，35，： | 1 |
| 5 | Mimosine attenuates Serine hydroxymethyltransferase transcription by chelating zinc:implications for inhibition of DNA replication显示文摘 | CHERYLL P RENUKA S ILYA M N | 2005 | J Biol Chem2005，280，1： | 1 |
| 6 | Multidisciplinary perspective of hepatocellular carcinoma: A Pacific Northwest experience显示文摘Hepatocellular carcinoma(HCC) is the most rapidly increasing type of cancer in the United States. HCC is a highly malignant cancer, accounting for at least 14000 deaths in the United States annually, and it ranks third as a cause of cancer mortality in men. One major difficulty is that most patients with HCC are diagnosed when the disease is already at an advanced stage, and the cancer cannot be surgically removed. Furthermore, because almost all patients have cirrhosis, neither chemotherapy nor major resections are well tolerated. Clearly there is need of a multidisciplinary approach for the management of HCC. For example, there is a need for better understanding of the fundamental etiologic mechanisms that are involved in hepatocarcinogenesis, which could lead to the development of successful preventive and therapeutic modalities. It is also essential to define the cellular and molecular bases for malignant transformation of hepatocytes. Such knowledge would:(1) greatly facilitate the identification of patients at risk;(2) prompt efforts to decrease risk factors; and(3) improve surveillance and early diagnosis through diagnostic imaging modalities. Possible benefits extend also to the clinical management of this disease. Because there are many factors involved in pathogenesis of HCC,this paper reviews a multidisciplinary perspective of recent advances in basic and clinical understanding of HCC that include: molecular hepatocarcinogenesis, noninvasive diagnostics modalities, diagnostic pathology, surgical modality, transplantation, local therapy and oncological/target therapeutics. | Matthew M Yeh Raymond S Yeung Smith Apisarnthanarax Renuka Bhattacharya Carlos Cuevas William P Harris Tony Lim Kiat Hon Siddharth A Padia James O Park Kevin M Riggle Sayed S Daoud | 2015 | World Journal of Hepatology2015，7，11： | 1 |
| 7 | Variation in physical characteristics of Kerala grown rattans of Peninsular India显示文摘 | Renuka C | 1986 | The Maylaysian Forestry1986，49，2： | 1 |
| 8 | Defucogilvocarcin V, a new antibiotic from Streptomyces arenae 2064: isolation, characterization, partial synthesis and biological activity显示文摘 | Renuka M Harold R T Ramesh C P | 1985 | J Antibiot1985，38，9： | 1 |
| 9 | Development of a water hyacinth based vermireactor using an epigeic earthworm Eisenia foetida显示文摘 | RENUKA G PRAVEEN K M NARESH K R | 2007 | Biores Tech2007，98，： | 1 |
| 10 | Energy consumption, economic growthand prices : a reassessment using panel VECM for developed anddeveloping countries显示文摘 | RENUKA M JOHN A A | 2007 | Energy Policy2007，35，4： | 1 |
| 11 | Testing the Accelerator Hypothesis : The relationship between body mass and age at diagnosis of type 1 diabetes显示文摘 | Kibirige M Metcalf B Renuka R | 2003 | Diabetes Care2003，26，10： | 1 |
| 12 | Variability of Soil Moisture and Its Relationship with Surface Albedo and Ther- mal Dif{usivity at Astronomical Observatory,Thiruvanantha- puram, South Kerala显示文摘 | Roxy M S Sumithranand V B Renuka G | 2010 | Journal Earth System Science2010，119，50： | 1 |
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