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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 | Cell adhesion molecules in rheumatoid arthritis 显示文摘 | Veale D J Maple C | 1996 | Drugs Aging1996，9，2： | 1 |
| 3 | Echinoderm faunas of the Hon-gguleleng Formation,Late Devonian(Famennian),Xinjiang-uygur Autonomous Region,People's Republic of China显示文摘 | Lane N G Waters J A Maples C G | 1997 | The Paleonto-logical Society Memoir1997，47，： | 1 |
| 4 | Fibrinogen and as- sociated risk factors in a high - risk population : urban indigenous Aus- tralians, the DRUID study 显示文摘 | Maple - Brown LJ Cunningham J Nandi N | 2010 | Cardiovascular Diabetology2010，9，11： | 1 |
| 5 | A quadrupling of Famen-man pelmatozoan diversity:new late Devonian blastoids and crinoids from northwest China显示文摘 | Waters J A Maples C G Lane N G | 2003 | Journal of Paleontology2003，77，5： | 1 |
| 6 | Depression and kidney transplantationE显示文摘 | Chileot J Spencer BW Maple H | 2014 | Transplantation2014，97，7： | 1 |
| 7 | Performance of a time-resolved fluorescence immunoassay for measuring varicella-zoster virus immunoglobulin G levels in adults and comparison with commercial enzyme immunoassays and Merck glycoprotein enzyme immunoassay显示文摘 | Maple PA Gray J Breuer J | 2006 | Clin Vaccine Immunol2006，13，2： | 1 |
| 8 | Efficacy of pazopanib in progressive, radioiodine-refractory, metastatic differentiated thyroid cancers: results of a phase 2 consortium study显示文摘 | Keith C Bible Vera J Suman Julian R Molina Robert C Smallridge William J Maples Michael E Menefee Joseph Rubin Kostandinos Sideras John C Morris Bryan McIver Jill K Burton Kevin P Webster Carolyn Bieber Anne M Traynor Patrick J Flynn Boon Cher Goh Hui Tan | 2010 | Lancet Oncology2010，，10： | 1 |
| 9 | An abinitio CFF93 all-atom forcefield for polyearbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | Journal of the American Chemical Society1994，116，7： | 1 |
| 10 | An ab initio CFF93 all-atom force field for polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | J Am Chem Soc1994，116，7： | 1 |
| 11 | Ab initio calculations on small molecule analogs of polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1995 | J Phy Chem1995，99，16： | 1 |
| 12 | The MMPI-2 and vocational assessment : A brief report显示文摘 | Westefeld J S Maples M | 1998 | Career Assessment1998，61，： | 1 |
| 13 | Advanced pancreatic cancer; A multi-institutional trial with gemeitabine and thalidomide显示文摘 | Maples WJ Stevenson J Sumrall SV | 2004 | J Clin 0ncol2004，22，14： | 1 |
| 14 | Plastid division is mediated by combinatorial assembly of plastid division proteins显示文摘 | Maple J Aldridge C Mqbller S G | 2005 | Plant Journal2005，43，6： | 1 |
| 15 | Performance of a time-resolved fluorescence immunoassay for measuring varicella- zoster virus immunoglobulin G levels in adults and comparison with commercial enzyme immunoassays and Merck glycoprotein enzyme immunoassay显示文摘 | Maple PA Gray J Breuer J | 2006 | Clin Vaccine Immunol2006，3，2： | 1 |
| 16 | Performance of a time-resolved fluorescence immunoassay for measuring varicella-zoster virus immunoglobulin G levels in adults and comparison with commercial enzyme immunoassays and Merck glycoprotein enzyme immunoassay显示文摘 | Maple PA Gray J Breuer J | 2006 | Clin Vaccine Immunol2006，13，2： | 1 |
| 17 | Lutein and zeaxanthin concentrations in rod outer segment membranes from perifoveal and peripheral human retina 显示文摘 | RAPP L M MAPLE S S CHOI J H | 2000 | Invest Ophthalmol Vis Sci2000，41，5： | 1 |
| 18 | Social attachment in giraffe:re sponse to social separation显示文摘 | Tarou L R Bashaw M J Maple T L | | 0，，01： | 1 |
| 19 | Comparison of fifteen commercial assays for detecting Varicella Zoster virus IgG with reference to a time resolved fluorescence immunoassay(TRFIA)and the performance of two commercial assays for screening sera from immunocompro-mised individuals显示文摘 | CHRIS MAPLE P A GUNN A SELLWOOD J | 2009 | J Virol Methods2009，155，2： | 1 |
| 20 | An ab initio CFFP3 all-atom force field for polycarbonates显示文摘 | Sun H Mumby S J Maple J R | 1994 | J Am Chem Soc1994，116，： | 1 |
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