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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 | Consensus Statements for Management of Barrett’s Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process显示文摘 | Cathy Bennett Nimish Vakil Jacques Bergman Rebecca Harrison Robert Odze Michael Vieth Scott Sanders Laura Gay Oliver Pech Gaius Longcroft–Wheaton Yvonne Romero John Inadomi Jan Tack Douglas A. Corley Hendrik Manner Susi Green David Al Dulaimi Haythem Ali | 2012 | Gastroenterology2012，，2： | 2 |
| 3 | The Influence of Total Nodes Examined, Number of Positive Nodes, and Lymph Node Ratio on Survival After Surgical Resection and Adjuvant Chemoradiation for Pancreatic Cancer: A Secondary Analysis of RTOG 9704显示文摘 | Timothy N. Showalter Kathryn A. Winter Adam C. Berger William F. Regine Ross A. Abrams Howard Safran John P. Hoffman Al B. Benson John S. MacDonald Christopher G. Willett | 2011 | International Journal of Radiation Oncology Biology Physics2011，，5： | 2 |
| 4 | Antibiotic resistance of enterococci isolated at a teaching hospital in Kuwait显示文摘 | Udo EE Al Sweih N John P | 2002 | Diagn Microbiol Infect Dis2002，43，3： | 1 |
| 5 | TNF-a acts via p38 MAPK to stimu-late expression of the ubiquitin ligase atroginl/MAFbx in skeletalmuscle显示文摘 | Li YP Chen Y John J e( al | 2005 | FASEB J2005，19，3： | 1 |
| 6 | Effect of passive smoking on birth-weight显示文摘 | David Peter John ct al | 1986 | Lancet1986，2，： | 1 |
| 7 | Antibiotic resistance of enterococ-ci isolated at a teaching hospital ill Kuwait 显示文摘 | Udo EE Al Sweih N John P | 2002 | Diagn Microbiol InfectDis2002，43，3： | 1 |
| 8 | Boerhaave's syndrome: a review ofmanagement and outcome 显示文摘 | Elain T Jonh E John D el al | 2007 | Interact CardioVase Thorac Surg2007，6，5： | 1 |
| 9 | Involvement of NADPH-de-pendent and cAMP-PKA sensitive H+ channels in the chor-datympani nerve responses to strong acids显示文摘 | John A Simone D Th T ez al | 2011 | Chem Senses2011，36，： | 1 |
| 10 | TNF, acting through inducibly expressed TNFR2, drives activation and cell cycle entry of c‐Kit<sup>+</sup> cardiac stem cells in ischemic heart disease显示文摘 | Rafia S. Al‐Lamki Wanhua Lu Jun Wang Jun Yang Timothy J. Sargeant Richard Wells Chenqu Suo Penny Wright Martin Goddard Qunhua Huang Amir H. Lebastchi George Tellides Yingqun Huang Wang Min Jordan S. Pober John R. Bradley | 2013 | Stem Cells2013，，9： | 1 |
| 11 | Margin clearance and outcome in resected pancreatic cancer显示文摘 | Chang DK Johns AL Merrett ND | 2009 | J Clin Oncol2009，27，17： | 1 |
| 12 | Biliary tract cancer显示文摘 | Ehrenfried John A Vauthey el al | 1999 | Curr Opin Gastroenterol1999，15，5： | 1 |
| 13 | Factors Associated With Mortality and Reoperation in 377 Children With Total Anomalous Pulmonary Venous Connection显示文摘 | Tara Karamlou Rebecca Gurofsky Eisar Al Sukhni John G. Coles William G. Williams Christopher A. Caldarone Glen S. Van Arsdell Brian W. McCrindle | 2007 | Circulation2007，，12： | 1 |
| 14 | Expression of p53 and 17p allelic loss in colorectal carcinoma显示文摘 | Cunningham J John AL Schaid DJ | 1992 | Cancer Res1992，52，： | 1 |
| 15 | Hybrid repairs of the distal aortic arch and proximal descending thoracic aorta 显示文摘 | John BM Scott AL Scott AW | 2007 | Operative Techniques in Thoracic and Cardiovascular Surgery2007，12，5： | 1 |
| 16 | Removal of thallium from aqueous solutions by modified Aspergillus niger biomass 显示文摘 | John Pete AL Viraraghavan T | 2008 | Bioresour Technol2008，99，： | 1 |
| 17 | A high-affinity subtype-selective agonist ligand for the thyroid hormone receptor显示文摘 | Grazia Chiellini James W. Apriletti Hikari Al Yoshihara John D. Baxter Ralff C.J. Ribeiro Thomas S. Scanlan | 1998 | Chemistry & Biology1998，，6： | 1 |
| 18 | A multiobjective modeling approach to locating incinerators显示文摘 | Luís Al?ada-Almeida Jo?o Coutinho-Rodrigues John Current | 2008 | Socio-Economic Planning Sciences2008，，2： | 1 |
| 19 | Clinical and immunohistochemical features of 34 solid pseudopapil- lary tumors of the pancreas显示文摘 | Nguyen NQ Johns AL Gill AJ | 2011 | J Gastroenterol Hepa- tol2011，26，2： | 1 |
| 20 | Calcium influx at the tip of growing root-hair cells of Arabidopsis thaliana显示文摘 | John W. Schiefelbein Al Shipley Paul Rowse | 1992 | Planta1992，，4： | 1 |
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