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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 | 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 |
| 3 | The MMPI-2 and vocational assessment : A brief report显示文摘 | Westefeld J S Maples M | 1998 | Career Assessment1998，61，： | 1 |
| 4 | 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 |
| 5 | 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 |
| 6 | 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 |
| 7 | Derivation of class II force fields, 1: Methodology and quantum forcefield for the alkyl functional group and alkane molecules显示文摘 | Maple J R Hwang M J Stockfisch T P | 1994 | Journal of Computational Chemistry1994，15，2： | 1 |
| 8 | Derivation of class II force fields, 3: Characterization of a quantum forcefield for the alkanes显示文摘 | Maple J R Hwang M J Stockfisch T P | 1994 | Israel Journal of Chemistry1994，34，1： | 1 |
| 9 | Social attachment in giraffe:response to social separation显示文摘 | Tarou L R Bashaw M J Maple T L | 2000 | Zoo Biol2000，19，： | 1 |
| 10 | Comparison of a commercial Varicella Zoster glycoprotein IgG enzyme immunoassay with a reference time resolved fluorescence immunoassay(VZV TRFIA)for measuring VZV IgG in sera from pregnant women,sera sent for confirmatory testing and pre and post vOka vaccination sera from healthcare workers显示文摘 | Maple PA Breuer J Quinlivan M | 2012 | J Clin Virol2012，53，3： | 1 |
| 11 | World-wild antibiotic resistance in methicillin- resistant Staphylococcus aureus显示文摘 | Maple P A Hamilton-Miller J M Brumfitt W | 1989 | Lancet1989，1，8637： | 1 |
| 12 | World-wide Antibictic Resitance in Methicllin-resistant Staphylococusanreus显示文摘 | Maple P A Hamihon-miller J M Brumlitt W | 1989 | Lancet1989，1，8637： | 1 |
| 13 | 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 |
| 14 | Separating nitrogen/methane on zeo- lite-like molecular sieves 显示文摘 | Maple M J Williams C D | 2008 | Microporous and Mesoporous Mate- rials2008，111，1： | 1 |
| 15 | World-wide antibiotic resistance in methicillin-resistant Staphylococcus aureus显示文摘 | Maple P A Hamilton-Miller J M Brumfitt W | 1989 | Lancet1989，1，8637： | 1 |
| 16 | The widespread oeeurrence of negative thermal expansion in zeolites显示文摘 | LIGHTFOOT P WOODCOCK D A MAPLE M J | 2001 | J Mater Chem2001，11，1： | 1 |
| 17 | Does wire guided cannulation prevent post ERCP panereatitis? A meta analysis显示文摘 | Madhoun M Te C C Stoner J Maple J T | 2009 | Gastrointest Endosc2009，69，： | 1 |
| 18 | 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 |
| 19 | Lutein and zeaxanthin concentrations in rod outer segment membranes from perifoveal and peripheral retina 显示文摘 | Rapp L M Maple S S Choi J H | 2000 | Invest Ophthalmol Vis Sci2000，41，5： | 1 |
| 20 | 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 |
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