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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 | Generation of cDNA probes directed by amino acid sequence: Cloning of urate oxidase 显示文摘 | Lee C C Wu X Gibbs R A | 1988 | Science1988，239，： | 2 |
| 3 | Contributing factorsin construction accidents 显示文摘 | HASLAM R A HIDE S A GIBB A G F | 2005 | Applied Ergonomics2005，36，40： | 1 |
| 4 | Deletion screening of the duchenne muscular dystrophy locus via multiplex DNA amplification 显示文摘 | CHAMBERLAIN J S GIBBS R A RANIER J E | 1988 | Nucleic Acids Res1988，16，23： | 1 |
| 5 | Insights into social insects from the genome of the honeybee Apis mellifera 显示文摘 | WEINSTOCK G M ROBINSON G E GIBBS R A | 2006 | Nature2006，443，： | 1 |
| 6 | Structural interactions between Kisspeptin and GnRH neurons in the me- diobasal hypothalamus of the male rhesus monkey (Maeaca mulatta) as revealed by double immunofluoreseenee and eonfo-al microscopy 显示文摘 | Ramaswamy S Guerriero K A Gibbs R B | 2008 | Endocrinology2008，149，9： | 1 |
| 7 | Production and characterization of bioactive peptides from soyhydrolysate and soy-fermented food显示文摘 | Gibbs BF Zougman A Masse R | 2004 | Food Research International2004，37，2： | 1 |
| 8 | Detection screening of the duchenne muscular dystrophy locus via mutiplex DNA amplification显示文摘 | Chambercian J S Gibbs R A Ranier J E | 1988 | Nucl Acids Res1988，16，： | 1 |
| 9 | Texture formation in bulk iron processed by simple shear显示文摘 | Gibbs M A Hartwig K T Cornwell L R | 1998 | Scr Mater1998，39，： | 1 |
| 10 | Production and characterization of bioactive peptides from soy hydrolysate and soy-fermented food 显示文摘 | Gibbs B F Zougman A Masse R | 2004 | Food Research International2004，37，2： | 1 |
| 11 | Deletion screening of the Duchenne muscular dystrophy locus via multiplex DNA am- plification 显示文摘 | Chamberlain J S Gibbs R A Rainer J E | 1988 | Nucleic Acids Res1988，16，11： | 1 |
| 12 | Histological typing of lung and pleural tumours: third edition 显示文摘 | Gibbs A R Thunnissen F B | 2001 | J Clin Pathol2001，54，7： | 1 |
| 13 | Pulverized coal combustion in air and in O2/CO2 mixtures with NOx recycle 显示文摘 | LIU H ZAILANI R GIBBS B A | 2005 | Fuel2005，84，16： | 1 |
| 14 | Production and characterization of bioactive peptides from soy hydrolysate and soy fermented food 显示文摘 | Gibbs B F Zoygman A Masse R | 2004 | Food Research Internetional2004，37，： | 1 |
| 15 | Deletion screening of Duchenne muscular dystrophy locus via multiplex DNA amplifica- tion显示文摘 | Chamberlain J S Gibbs R A Ranier J E | 1988 | Nucleic Acid Res1988，16，11： | 1 |
| 16 | Deletion screening of the Duchenne muscular dystrophy locus via multiplex DNA amplification 显示文摘 | Chamberlain J S Gibbs R A Ranier J E | 1988 | Nucleic Acids Res1988，16，11： | 1 |
| 17 | Development of the lateral line system in the shovelnose sturgeon 显示文摘 | Gibbs M A Northcutt R G | 2004 | Brain Behavior and Evolution2004，64，2： | 1 |
| 18 | Molecular complexes of nucleosides and nucleotides with a monomeric cationic perphyfin and some of its metal derivatives显示文摘 | PASTERNACK R F GIBBS E J GAUDEMER A | 1985 | J Am Chem Soc1985，107，： | 1 |
| 19 | Detection screening of the duchenne muscular dystrophy locus via multiplex DNA amplification显示文摘 | Chambercian J S Gibbs R A Ranier J E | 1988 | Nucl Acids Res1988，16，： | 1 |
| 20 | Ruthenium(Ⅲ) chloride-catalyzed chemoselective synthesis of acetals from aldehydes 显示文摘 | De S K Gibbs R A | 2004 | Tetrahedron Lett2004，45，： | 1 |
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