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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 | PCI proteins eIF-3e and eIF-3m define distinct translation initiation factor 3 complexes 显示文摘 | Zhou C Arslan F Wee S | 2005 | BMC Biol2005，3，： | 1 |
| 3 | The effect of bias voltage and working pressure on S/Mo ratio at MoS2-Ti composite films 显示文摘 | Btilbiil F Efeoglul Arslan E | 2007 | Applied Surface Science2007，253，： | 1 |
| 4 | Exosome secreted by MSC re- 显示文摘 | Lai RC Arslan F Lee MM | 2010 | Stem Cell Res2010，4，3： | 1 |
| 5 | Current progress on understanding microRNAs in glioblastoma multiforme显示文摘 | Karsy M Arslan E Moy F | 2012 | Genes Cancer2012，3，1： | 1 |
| 6 | Innate immune signa- ling in cardiac ischemia 显示文摘 | Arslan F de Kleijn D P Pasterkamp G | 2011 | Nat Rev Cardiol2011，8，5： | 1 |
| 7 | Flow properties of cellulose andcarboxymethyl cellulose from orange peel显示文摘 | YASAR F TOGRUL H ARSLAN N | 2007 | Journal of Food Engineering2007，81，1： | 1 |
| 8 | Exosome secreted byMSC reduces myocardial ischemia/reperfusion injury显示文摘 | Lai RC Arslan F Lee MM | 2010 | Stem Cell Res2010，4，3： | 1 |
| 9 | Carbon isotope discrimi- nation as indicator of water use efficiency of spring wheat as affected by salinity and gypsum additions显示文摘 | Arslan A Zapata F Kumarasinghe K S | 1999 | Communications in Soil Sci- ence and Plant Analysis1999，30，： | 1 |
| 10 | Inhibition of R1P1 -dependent necrosis prevents adverse cardiac remodeling after myocardial is- chemia - reperfusion in vivo显示文摘 | Oerlemans M I Liu J Arslan F | 2012 | Basic Res Cardiol2012，107，4： | 1 |
| 11 | A useful method for the de- tection of ethylenediaminetetraacetic acid-and cold agglutinin-de- pendent pseudothrombocytopenia显示文摘 | Ozcelik F Arslan E Serdar MA | 2012 | Am J Med Sci2012，344，5： | 1 |
| 12 | Noise exposure in neonatal intensive care units显示文摘 | Magnavita V Arslan E Benini F | 1994 | Acta Otorhinolaryngol Ital1994，，14： | 1 |
| 13 | Imported Plasmodium falci- parum malaria in Istanbul, Turkey: risk factors for severe course and mortality显示文摘 | Arslan F Mert A Batirel A | 2013 | Trop Doct2013，43，4： | 1 |
| 14 | Relationship between postoperative recurrence rale and eosinophil density of nasal polyps 显示文摘 | Tosun F Arslan HH Ka slioglu Y | 2010 | Ann Otol Rhinol Laryngol2010，119，7： | 1 |
| 15 | Exosome secreted by MSC reduces myocardial ischemia/reperfusion injury 显示文摘 | Lai R C Arslan F Lee M M | 2010 | Stem Cell Res2010，4，3： | 1 |
| 16 | eNOS Glu298Asp gene polymorphism in the cases of idiopathic thrombocytopenic purpura 显示文摘 | Arslan F Akarsu S Kara M | 2009 | J Thrombosis and Haemostasis2009，7，2： | 1 |
| 17 | Enabling a robust scalablemanufacturing process for therapeutic exosomes through oncogenicimmortalization of human ESC-derived MSCs显示文摘 | Chen T S Arslan F Yin Y | 2011 | J Transl Med2011，9，47： | 1 |
| 18 | Exosome secreted by MSC reduces myocardial ischemia/reperfusion injury 显示文摘 | Lai RC Arslan F Lee MM | 2010 | Stem Cell Res2010，4，3： | 1 |
| 19 | Mesenchymal stem cell derived exosomes increase ATP levels, decrease oxidative stress and activate PI3K/Akt pathway to enhance myocardial viability and prevent adverse remodeling after myocardial ischemia/reperfusion injury显示文摘 | Arslan F Lai RC Smeets MB | 2013 | Stem Cell Res2013，10，3： | 1 |
| 20 | Imported Plasmodium falciparum malaria in Istanbul,Turkey:risk factors for severe course and mortality显示文摘 | Arslan F Mert A Batirel A el al | 2013 | Trop Doct2013，43，4： | 1 |
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