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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 | Medication taking in coronary artery disease : a systematic review and qualitative synthesis显示文摘 | Rashid MA Edwards D Walter FM ct al | 2014 | Ann Fam Med2014，12，3： | 1 |
| 3 | DNA typing and geneticmapp ingwith trimeric and tetrameric tandem repeats 显示文摘 | Edwards AL Civitello A | 1991 | Am J Hum Genet1991，49，4： | 1 |
| 4 | Requirement of aquaporin-1 for NaCl-driven water transport across descending vasa recta 显示文摘 | Pallone TL Edwards A Ma T at al | 2000 | J Clin Invest2000，105，： | 1 |
| 5 | Presence of diosgenin in Di- oscorea batatas ( Dioscoreaceae ) 显示文摘 | Edwards AL Jenkins R | 2002 | Economic Botany/ The Society of Economic Botany2002，56，2： | 1 |
| 6 | Primary pulmonary hypertension:natural history and the importance of thrombosis显示文摘 | Fuster V Steele PM Edwards WD el al | 1984 | Circulation1984，70，4： | 1 |
| 7 | NHSN annual update:antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to theNational Healthcare Safety Network at the Centers for DiseaseControl and Prevention, 2006-2007显示文摘 | Hidron Al Edwards JR Patel J | 2008 | Infect Control HospEpidemiol2008，29，11： | 1 |
| 8 | Reduction of maternal-infant transmission of HIV type 1 with zidovudine treatment显示文摘 | Edward M Connor Rhoda S Sperling Richard Gelber et al | 1994 | New England Journal of Medicine1994，331，： | 1 |
| 9 | DNA typing and genetic mapping withtrimeric and tetrameric tandem repeats显示文摘 | Edwards Al Civitello A Hammond HA | 1991 | Am J Hum Genet1991，49，74： | 1 |
| 10 | Sub-pixel measurements using a moment-based edge operator显示文摘 | Edward P lyvers Owen Robert Mitchell Mark L Akey et al | 1989 | IEEE Trans PAMI1989，11，12： | 1 |
| 11 | DNA typing and genetic mapping with trimeric and tettramertic tandem repeat显示文摘 | Edwards AL Civitello A | 1991 | Am J Hum Genet1991，49，4： | 1 |
| 12 | A Bayesian neu-ral network method for adverse drug reaction signal generation显示文摘 | BATE A LINDQUIST M EDWARDS IR ei al | 1998 | Eur J Clin Pharmacol1998，54，4： | 1 |
| 13 | NHSN annual update:antimicrobial-resistant pathogens associated with health care-associated infections:annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention,2006-2007显示文摘 | Hidron Al Edwards JR Patel J | 2008 | Infect Control Hosp Epidemiol2008，29，： | 1 |
| 14 | A comparison of the Thurstone and Likert techniques of attitude scale construction 显示文摘 | Edwards AL Kenney KC | 1946 | Applied Psvchology1946，30，1： | 1 |
| 15 | A 21st century HPLC workflow for process R and D显示文摘 | Karcher Brent D Davies Merrill L Delaney Edward J ct al | 2005 | Jala J Assoc Lab Autom2005，10，6： | 1 |
| 16 | Intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy:Current status and future directions显示文摘 | Perry S Edward AL | 2005 | Ann Surg Oneol2005，12，10： | 1 |
| 17 | F'emale reproductivedisorders : the roles of endocrine-disrupting compounds anddevelopmental timing显示文摘 | Crain D A Janssen S J Edwards T M al | 2008 | Fertility and Sterility2008，90，4： | 1 |
| 18 | Energy and Transport显示文摘 | James Woodcock David Banister Phil Edwards et al | 2007 | The Lancet2007，，370： | 1 |
| 19 | Low molecular weight organic acid adsorption in forest soils: effects on soil solution concentrations and biodegradation rates 显示文摘 | Van Hees P A W Vinogradoff S I Edwards ct al | 2003 | Soil Biology & Biochemistry2003，35，： | 1 |
| 20 | Prediction of op- erative mortality after valve replacement surgery显示文摘 | Edwards FH Peterson ED Coombs LP ei al | 2001 | Am Coll Cardiol2001，37，3： | 1 |
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