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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 | Speaker transformation algorithm using segmental codebooks (STASC) 显示文摘 | LEVENT ARSLAN M | 1999 | Speech Communication1999，2，8： | 1 |
| 3 | Techniques of laryngeal reconstruction 显示文摘 | | 1974 | Laryngoscope1974，7，： | 1 |
| 4 | Outcome of open comminuted tibial plateau fractures treated using an external fixator显示文摘 | Subasi M Kapukaya A Arslan H | 2007 | J Orthop Sci2007，12，： | 1 |
| 5 | Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery 显示文摘 | Isik B Arslan M Tunga A D | 2006 | Paediatr Anaesth2006，16，7： | 1 |
| 6 | Treatment of viable cesarean scar ectopic pregnancy with suction curettage显示文摘 | Arslan M Pata O Dilek TU | 2005 | Int J Gynecol Obstet2005，89，2： | 1 |
| 7 | Efficacy and toxic- ity of gemcitabine and pegylated liposomal Doxorubicin in recurrent platinum-resistant/refractory epithelial ovarian cancer显示文摘 | Karaoglu A Arslan UY Ozkan M et a/ | 2009 | Asian Pac J Cancer Prey2009，10，1： | 1 |
| 8 | Analytical modeling of post- tensioned precast beam-to-column connections 显示文摘 | Kaya M Arslan A | 2009 | Materials and Design2009，30，9： | 1 |
| 9 | Dexmedetomidine decreaesemergence agitation in pediatric patients after sevofluraneanesthesia without surgery 显示文摘 | Isik B Arslan M Tunga AD | 2006 | Pediatric Anesthesia2006，16，7： | 1 |
| 10 | Current progress on understanding microRNAs in glioblastoma multiforme显示文摘 | Karsy M Arslan E Moy F | 2012 | Genes Cancer2012，3，1： | 1 |
| 11 | Estimation of Flexural Capacity of Quadrilateral FRP-Confined RC Columns Using Combined Artificial Neural Network 显示文摘 | Koroglu M A Ceylan M Arslan M H | 2012 | Engineering Structures2012，42，： | 1 |
| 12 | Speaker transformation algorithm using segmental codebooks显示文摘 | L M Arslan | 1999 | Speech Communication1999，28，3： | 1 |
| 13 | Use of CA15-3 ,CEA and prolactin for the primary diagnosis of breast cancer and correlation with the prognostic factors at the time of initial diagnosis显示文摘 | Arslan N Serdar M Deveci S | 2000 | Ann Nucl Med2000，14，： | 1 |
| 14 | Single - dose methotrexate for the- treatment of unruptured ectopic pregnancy 显示文摘 | Erdem M Erdem A Arslan M | 2004 | Arch Gynecol Ob- stet2004，270，4： | 1 |
| 15 | A nuclear poly (ADP-ribose)- dependent signalosome confers DNA damage-induced IKappaB ki- nase activation显示文摘 | Stilmann M Hinz M Arslan SC | 2009 | Mol Cell2009，36，3： | 1 |
| 16 | Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease显示文摘 | Hüseyin Per Duran Arslan Hakan Gümü? Abdulhakim ?oskun Sefer Kumanda? | 2013 | Neurological Sciences2013，，1： | 1 |
| 17 | Relationship between Nterminal pro-B type natriuretic peptide and extensive echocarciographic parameters in mild to moderate aortic stenosis显示文摘 | Cemri M Arslan U Kocaman SA | 2008 | J Postgrac Med2008，54，1： | 1 |
| 18 | SERUM mf - IL - 6 Lupus anticoagulant and anticardiolpin antibody in women with and without a ast history of recurrent iscariage 显示文摘 | Arslan E Colakoglu M Ceelik C | 2004 | Arch Gynecol Obstet2004，270，4： | 1 |
| 19 | The effect of melatonin bleo-mycin-induced pulmonary fibrosis in rats显示文摘 | Arslan SO’Zerin M Vural H eJ al | 2002 | J Pineal Res2002，32，1： | 1 |
| 20 | Treatment of viable cesarean scar ectopic pregnancy with suction curettage 显示文摘 | Arslan M Pata O Dilek T U | 2005 | Int J Gynaecol Obstet2005，89，2： | 1 |
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