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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 | Generation of cDNA probes directed by amino acid sequence: Cloning of urate oxidase 显示文摘 | Lee C C Wu X Gibbs R A | 1988 | Science1988，239，： | 2 |
| 3 | Term Arising from Similar Dissimilar Electrons 显示文摘 | Gibbs R C Wilber D T White H E | 1927 | Phys Rev1927，29，6： | 2 |
| 4 | Spilling the beans on understanding and memory of idioms显示文摘 | GIBBS R | 1980 | Memory and Cognition1980，，8： | 1 |
| 5 | Cofactor regeneration of NAD from NADH: Novel water-forming NADH oxidases显示文摘 | Riebel B R Gibbs P R Wellborn W B | 2002 | Advanced Synthesis and Catalysis2002，344，10： | 1 |
| 6 | Raman spectroscopic library of natural and synthetic pigments (pre-- 1850 AD)显示文摘 | Bell I M Clark R J H Gibbs P J | 1997 | Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy1997，53，12： | 1 |
| 7 | Raman spectroscopic library of natural and synthetic pigments (pre- 1850AD) 显示文摘 | Bell I M Clark R J H Gibbs P J | 1997 | Spectrochim Acta Part A: Mol Biomol Spectr1997，53，12： | 1 |
| 8 | Effect of turning regime and seasonal weather conditions on nitrogen and phosphorus losses during aerobic composting of cattle manure 显示文摘 | Parkinson R Gibbs P Burehett S | 2004 | Bioresource Technology2004，91，： | 1 |
| 9 | Contributing factorsin construction accidents 显示文摘 | HASLAM R A HIDE S A GIBB A G F | 2005 | Applied Ergonomics2005，36，40： | 1 |
| 10 | Deletion screening of the duchenne muscular dystrophy locus via multiplex DNA amplification 显示文摘 | CHAMBERLAIN J S GIBBS R A RANIER J E | 1988 | Nucleic Acids Res1988，16，23： | 1 |
| 11 | Surfactant-enhanced remediation of contaminated soil,a review显示文摘 | MULLIGAN C N YONG R N GIBBS B F | | Engineering Geology0，60，： | 1 |
| 12 | Heavy metal removal from sedimends by biosurfactants显示文摘 | Mulligan C N Yong R N Gibbs B F | 2001 | Journal of Hazardous Material2001，，85： | 1 |
| 13 | Insights into social insects from the genome of the honeybee Apis mellifera 显示文摘 | WEINSTOCK G M ROBINSON G E GIBBS R A | 2006 | Nature2006，443，： | 1 |
| 14 | Categorization and Metaphor Understanding显示文摘 | Gibbs R W | 1980 | Psychological Review1980，，10： | 1 |
| 15 | The integration of information retrieval techniques within a soft- ware reuse environment显示文摘 | GIBB F MCCARTAN C O'DONNELL R | 2000 | Journal of Information Science2000，26，4： | 1 |
| 16 | Themathematical modeling of hot rolling 显示文摘 | Hodgson P D Mcfarlane D Gibbs R K | 1987 | Journal ofJapan Society for Technology of Plasticity1987，28，： | 1 |
| 17 | Structural interactions between Kisspeptin and GnRH neurons in the me- diobasal hypothalamus of the male rhesus monkey (Maeaca mulatta) as revealed by double immunofluoreseenee and eonfo-al microscopy 显示文摘 | Ramaswamy S Guerriero K A Gibbs R B | 2008 | Endocrinology2008，149，9： | 1 |
| 18 | Production and characterization of bioactive peptides from soyhydrolysate and soy-fermented food显示文摘 | Gibbs BF Zougman A Masse R | 2004 | Food Research International2004，37，2： | 1 |
| 19 | Mechanisms controlling world water chemistry显示文摘 | GIBBS R J | 1970 | Science1970，170，： | 1 |
| 20 | Liposomal amphoterlcin B: clinical experience and perspectives显示文摘 | GIBBS W J DREW R H PERFECT J R | 2005 | Eepert Rev Anti Infect Ther2005，3，2： | 1 |
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