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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 | Small doses of high-linear energy transfer radiation increase the radioresistance of Chines Hamster V79 cells to subsequent X irradiation显示文摘 | Maples B Skov KA | 1996 | Radiat Res1996，146，： | 1 |
| 3 | On the formation of LnCeOy ( Ln = Nd, Pr, Sin, Eu) solid solution 显示文摘 | Jardim R F Maple M B | 1993 | Mater Lett1993，18，12： | 1 |
| 4 | Superconductivity and Normal-state Properties of ThU Alloys显示文摘 | COLES B R MAPLE M B HUBER J G | 1970 | Journal of Low Temperature Physics1970，3，2： | 1 |
| 5 | High-temperature superconductivity 显示文摘 | Maple M B | 1998 | Journal of Magnetism and Magnetic Materials1998，181，： | 1 |
| 6 | Improved superconducting properties of MgB2显示文摘 | Li S Maple M B | 2001 | Physica C2001，363，： | 1 |
| 7 | Prolonged production of NADPH oxidase-corrected granulocytes after gene therapy of chronic granulomatous disease显示文摘 | Malech H L Maples P B Whiting-Theobald N | 1997 | Proc Natl Acad Sci USA1997，94，12： | 1 |
| 8 | The Arabidopsis DJ-1aprotein confers stress protectionthrough cytosolic SOD activation显示文摘 | Xu X M Lin H Maple J Bjrkblom B Alves G Larsen J P etal | 2010 | J Cell Sci2010，123，： | 1 |
| 9 | Optimized solvent-exchange synthesis method for C60 colloidal dispersions显示文摘 | Maples R D Hilburn M E Murdianti B S | 2012 | Journal of Colloid and Interface Science2012，370，1： | 1 |
| 10 | Superconductivity and normalstate properties of ThU alloys显示文摘 | Maple M B etal | 1970 | Journal of Low Temperature Physics1970，3，2： | 1 |
| 11 | Specific-Heat Anomalies at the Lower Critical Temperature in Reentrant Ferromagnetic Superconductors 显示文摘 | Maple M B MacKay H B Woolf L D | 1979 | Phys Rev Lett1979，43，： | 1 |
| 12 | Thermoelectric properties of chemically substituted skutterudites YbyCo4SnxSb12-x 显示文摘 | Dilley N R Bauer E D Maple M B | 2000 | Journal of Applied Physics2000，88，7： | 1 |
| 13 | How to overcome ( and exploit) tumor hypoxia for targeted gene therapy 显示文摘 | Greco O Maples B Joiner MC | 2003 | J Cell Physoil2003，197，3： | 1 |
| 14 | 显示文摘 | Dilley N R Gajewski D A Bauer E D Freeman E J Chau R Mandrus D Sales B C | 1999 | Phys Rev B1999，256，： | 1 |
| 15 | Stathmin 1: a novel therapeutictarget for anticanxer activity 显示文摘 | Rana S Maples P B Senzer N | 2008 | Expert Rev Anticancer Ther2008，8，9： | 1 |
| 16 | Wireless capsule endoscopy 显示文摘 | WANG A BANERJEE S BARTH B A BHAT Y M CHAUHAN S GOTTLIEB K T KONDA V MAPLE J T MURAD F PFAU P R PLESKOW D K SIDDIQUI U D TOKAR J L RODRIGUEZ S A | 2013 | Gastrointestinal Endoscopy2013，78，6： | 1 |
| 17 | Stathmin 1:a novel therapeutic target for anticancer activity显示文摘 | Rana S Maples P B Senzer N | 2008 | Expert Rev Anticancer Ther2008，8，9： | 1 |
| 18 | Com- parison of distance and near heterophoria by two clinical meth- ods显示文摘 | Maples WC Savoy RS Harville B J Golden LR Hoenes R | 2009 | Optom Vis Dev2009，40，2： | 1 |
| 19 | Topics in Current Physics显示文摘 | Maple M B Fisher O | | 0，，： | 1 |
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