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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 | Regional cerebral blood flow correlated with flashback intensity in patients with posttraumatic stress disorder显示文摘 | Osuch EA Benson B Geraci M | 2001 | Biol Psychiatry2001，50，4： | 1 |
| 3 | Identity consequences of attachment to mothers and fathers among late adolescents显示文摘 | Benson M J Harris P B Rogers C S | | 0，，02： | 1 |
| 4 | Effects of sensor spatial resolution on landscape structure parameters显示文摘 | Benson B J MacKenzie M D | 1995 | Land- scape Ecology1995，10，2： | 1 |
| 5 | Effects of sensor spatial resolution on landscape structure parameters显示文摘 | BENSON B J MACKENZIE M D | 1995 | Landscape Ecology1995，10，2： | 1 |
| 6 | Design, synthesis, and circu- lar dichroism investigation of a peptide--Sandwiched mesoheme 显示文摘 | Benson D R Hart B R Zhu X | 1995 | J Am Chem Soc1995，117，33： | 1 |
| 7 | Hydraulic conductivity of a dense prehydrated GCL permeated with aggressive inorganic solutions 显示文摘 | Kolstad D C Benson C H Edil T B | 2004 | Geosynthetics International2004，11，3： | 1 |
| 8 | Comparing ICP and ECR Etching of HgCdTe, CdZnTe and CdTe 显示文摘 | A J Stohz J B Varesi J D Benson | 2007 | Journal of Electronic Materials2007，36，8： | 1 |
| 9 | The unique enve lope gene of the subgroup J avian leukosis virus de rives from ev/J provirus, a novel family of avian en dogenous viruses显示文摘 | Benson S J Ruis B Fadly A M | 1998 | J Virol1998，72，10： | 1 |
| 10 | Subordinated advection-dispersion equation for contaminant transport显示文摘 | BAEUMER B MEERSCHAERT M M BENSON D A | 2001 | Water Resources Research2001，37，6： | 1 |
| 11 | Web-based phylogenetic assignment tool for analysis of terminal restriction fragment length polymorphism profiles of microbial communities显示文摘 | Kent A D Smith D J Benson B J | 2003 | Applied and Environmental Microbiology2003，69，11： | 1 |
| 12 | DNA mi- croarrays to study gene expression in allergic airways 显示文摘 | Benson M Svensson PA Carlsson B | 2002 | Clin Exp Allergy2002，32，2： | 1 |
| 13 | Mobilization of Cr (VI) from chromite ore processing residue through acid treatment显示文摘 | Tinjum J M Benson C H Edii T B | 2008 | Science of the Total Environment2008，391，1： | 1 |
| 14 | Wisteria floribunda lectin is associated with specific cell types in the ventral cochlear nucleus of the gerbil, Meriones unguiculatus 显示文摘 | Cant N B Benson C G | 2006 | Hearing Research2006，6，216： | 1 |
| 15 | Propagation and attenuation in the double- strip H guide显示文摘 | R F B Conlon and F A Benson | | Proc IEE0，1966，： | 1 |
| 16 | Biology of Frankia strains, actinomycete symbionts of actinorhizal plants 显示文摘 | Benson D R Silvester W B | 1993 | Microbiological Reviews1993，57，： | 1 |
| 17 | Scientific Considerations Related to Regulation Development for CO2 Sequestration in Brine Formations显示文摘 | Tsang C F Benson S M Kobelski B | 2002 | Environmental Geology2002，42，23： | 1 |
| 18 | Usefulnessof ultrasonography in the management of nodular thyroid disease显示文摘 | MARQUSEE E BENSON C B FRATES M C | 2000 | Ann Intern Med2000，133，9： | 1 |
| 19 | Particle size effect on strength,failure,and shock behavior in polytetrafluoroethylene-Al-W granular composite materials显示文摘 | Herbold E B Nesterenko V F Benson D J | 2008 | Journal of Applied Physics2008，104，10： | 1 |
| 20 | Web-based phylogenetic assignment in tool for analysis of terminal restriction fragmentlength polymorphism profiles of microbial communities显示文摘 | Kent A D Smith D J Benson B J | 2003 | Ap- plied and Environmental Microbiology2003，69，67： | 1 |
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