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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 | Development and verification of a one-dimensional ablation code including pyrolysis gas flow 显示文摘 | Amar A J Blackwell B F Edwards J R | 2009 | Journal of Thermophysics and Heat Transfer2009，23，1： | 1 |
| 3 | Effi- cacy of pyropheophorbide-α-hexyl ether for photody- namic therapy of rat 9L gliosareoma显示文摘 | AUTRY S A EDWARDS B F BOGGAN J E | 1993 | Optical Methods for Tumor Treatment and Detection1993，，： | 1 |
| 4 | Membrane ther- mostability and heat tolerance of spring wheat 显示文摘 | Shanahan J F Edwards I B Quick J S | 1990 | Crop Sci- ence1990，30，2： | 1 |
| 5 | OMEGA EP high-energy petawatt laser: progress and prospects显示文摘 | D N Maywar J H Kelly L J Waxer S F B Morse I A Begishev J Bromage C Dorrer J L Edwards L Folnsbee M J Guardalben S D Jacobs R Jungquist T J Kessler R W Kidder B E Kruschwitz S J Loucks J R Marciante R L McCrory D D Meyerhofer A V Okishev J B Oliver G Pien | 2008 | Journal of Physics: Conference Series2008，，3： | 1 |
| 6 | Structural Characterization of the Released Polysaccharide of Desiccation-Tolerant Nostoc commune DRH-1 显示文摘 | Helm R F Huang Z B Edwards D | 2000 | J Bact2000，182，4： | 1 |
| 7 | Reliability assessment of electronic components exposed to long-term non-operating conditions显示文摘 | Patrick F Cluskey M Edward B | 1998 | IEEE Transactions on Components Packaging and Manufacturing Technology-Part A1998，21，2： | 1 |
| 8 | Community genomics among stratified microbial assemblages in the ocean's interior显示文摘 | DeLong E F Preston C M Mincer T Rich V Hallam S J Frigaard N U Martinez A Sullivan M B Edwards R Brito B R Chisholm S W Karl D M | | 0，，5760： | 1 |
| 9 | Experimental determination of the fate of rising co2 droplets in seawater显示文摘 | PETER G B EDWARD T P GERNOT F | 2002 | Environ Sci Technol2002，36，： | 1 |
| 10 | Two cytosolic glutamine synthetase isoforms of maize are specifically involved in the control of grain production 显示文摘 | Martin A Lee J Kichey T Gerentes D Zivy M Tatout C Dubois F Balliau T Valot B Davanture M Laforgue T T Quillere I Coque M Gallais A Moro M B G Bethencourt L Habash D Z Lea P J Charcosset A Perez P Murigneux A Sakakibara H Edwards K J Hirel B | 2006 | The Plant Cell2006，18，11： | 1 |
| 11 | Isotope Dilution Mass Spectrometry and the National Reference System显示文摘 | George B John F Edward W | | 0，，12： | 1 |
| 12 | Liposomal prostaglandin E1 in acute respiratory distress syndrome: A controlled, randomized, double-blind, multicenter clinical trial显示文摘 | Edward A Robert B Eugene F | 1999 | Crit Care Med1999，27，8： | 1 |
| 13 | A numerical study of the measurement of elongational viscosity of polymeric fluids in a semihyperbolically converging die显示文摘 | Feigl K Tanner X F Edwards B J | 2003 | Journal of Non- Newtonian Fluid Mechanics2003，115，23： | 1 |
| 14 | Development and verification of a one-dimensional ablation code including py- rolysis gas flow 显示文摘 | Amar A J Blackwell B F Edwards J R | 2009 | Journal of Thermophysics and Heat Transfer2009，23，1： | 1 |
| 15 | Theory of powders显示文摘 | Edwards S F Oakeshott R B S | 1989 | Physica A1989，157，： | 1 |
| 16 | One-dimensional ablation using a full Newton’s method and finite control volume procedure显示文摘 | AMAR A J BLACKWELL B F EDWARDS J R | 2008 | Journal of Thermophysics and Heat transfer2008，22，1： | 1 |
| 17 | Reliability assessment of electronic components exposed to long-term non-operating conditions显示文摘 | Patrick F Cluskey M Edward B | 1998 | IEEE Transactions on Components Packaging and Manufacturing Technology--Part A1998，21，2： | 1 |
| 18 | Percolation model for simulation of char oxidation and fragmentation timehistories显示文摘 | KERSTEIN A R EDWARDS B F | 1987 | Chemical Engineering Science1987，42，7： | 1 |
| 19 | The transmission of stress in an aggregate显示文摘 | Edwards S F Oakeshott R B S | 2005 | Physica D2005，38，： | 1 |
| 20 | Mutations in filamin 1 Prevent Migration of Cerebral Cortical Neurons in Human Periventricular Heterotopia显示文摘 | Jeremy W Fox Edward D Lamperti Yaman Z Ek?io?lu Susan E Hong Yuanyi Feng Donna A Graham Ingrid E Scheffer William B Dobyns Betsy A Hirsch Rodney A Radtke Samuel F Berkovic Peter R Huttenlocher Christopher A Walsh | 1998 | Neuron1998，，6： | 1 |
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