References of "LOUIS, Renaud"
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See detailBudesonide/formoterol maintenance and reliever therapy versus conventional best practice.
Demoly, Pascal; Louis, Renaud ULg; Soes-Petersen, Ulrik et al

in Respiratory medicine (2009), 103(11), 1623-32

Budesonide/formoterol maintenance and reliever therapy (Symbicort SMART) reduces asthma exacerbations and symptoms versus fixed-dose regimens plus short-acting beta(2)-agonists (SABA) in double-blind ... [more ▼]

Budesonide/formoterol maintenance and reliever therapy (Symbicort SMART) reduces asthma exacerbations and symptoms versus fixed-dose regimens plus short-acting beta(2)-agonists (SABA) in double-blind trials. Information is lacking regarding its effectiveness versus conventional best practice (CBP). This pooled analysis of six 6-month, randomized, open-label studies examined asthma control and exacerbation risk in asthmatics (aged> or =12 years). Patients (N=7855) symptomatic on inhaled corticosteroids (ICS) or stable/symptomatic on ICS/long-acting beta(2)-agonists (LABA) received budesonide/formoterol maintenance and reliever therapy (160/4.5microg bid and as needed) or CBP (ICS or ICS/LABA+/-other agents at an approved dose plus as-needed SABA). Overall asthma control was assessed comparing the incidence of exacerbations and levels of asthma control using the asthma control questionnaire (ACQ). Budesonide/formoterol maintenance and reliever therapy did not significantly reduce time to first severe exacerbation (primary variable) versus CBP (P=0.062). However, patients in this group experienced 15% fewer exacerbations (0.20 versus 0.24/patient/year; P=0.021) and used 27% less ICS (P<0.0001). Odds of remaining well controlled (ACQ< or =0.75) over 6 months were higher with budesonide/formoterol maintenance and reliever therapy versus CBP (45% versus 41%, odds ratio [OR] 1.29; P<0.01) while risk of remaining uncontrolled decreased (25% versus 29%, OR 0.81; P<0.01). Budesonide/formoterol maintenance and reliever therapy improves key aspects of asthma control versus physicians' choice of CBP. [less ▲]

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See detailEffects of ciclesonide and fluticasone on cortisol secretion in patients with persistent asthma.
Derom, E.; Louis, Renaud ULg; Tiesler, C. et al

in European Respiratory Journal (2009), 33(6), 1277-86

We compared the systemic and clinical effects of ciclesonide (CIC) and fluticasone propionate (FP) administered, in addition to CIC 160 microg x day(-1) and salmeterol 50 microg twice daily, in 32 ... [more ▼]

We compared the systemic and clinical effects of ciclesonide (CIC) and fluticasone propionate (FP) administered, in addition to CIC 160 microg x day(-1) and salmeterol 50 microg twice daily, in 32 patients with persistent asthma using a randomised double-blind, placebo-controlled, double-dummy, five-period crossover design. All patients exhibited a provocative concentration leading to a 20% decrease in forced expiratory volume in 1 s (PC(20)) methacholine <8 mg x mL(-1) and a PC(20) adenosine <60 mg x mL(-1). Primary outcome was 24-h serum cortisol suppression after 7 days. Secondary outcomes were changes in PC(20) methacholine and adenosine after 9 days. FP 500 microg x day(-1) and 1,000 microg x day(-1) significantly suppressed cortisol secretion versus placebo by -46.2 (95% confidence interval (CI) -83.8- -8.5) nmol x L(-1) and by -76.1 (95% CI -112.9- -39.3) nmol x L(-1), respectively. Neither dose of CIC (320 nor 640 microg x day(-1)) had a significant suppressive effect (-28.2 (95% CI -65.5-9.2) nmol x L(-1) and -37.3 (95% CI -74.7-0.0) nmol x L(-1), respectively). Differences between FP 1,000 microg x day(-1) and both CIC treatments were statistically significant (CIC 320 microg x day(-1): -48.0 (95% CI -84.8- -11.1) nmol x L(-1); CIC 640 microg x day(-1): -38.8 (95% CI -75.7- -1.9) nmol x L(-1)). Compared with placebo, the increase in PC(20) adenosine after the four treatments was small, but significant. Greater improvements in PC(20) adenosine were seen with FP 500 microg x day(-1) (1.8 (95% CI 1.0-2.6) doubling concentrations) compared with CIC 320 microg x day(-1) (0.9 (95% CI 0.1-1.7) doubling concentrations). No significant difference was seen between CIC 640 microg x day(-1) and FP 1,000 microg x day(-1). For a similar decrease in hyperresponsiveness, cortisol secretion was suppressed significantly with moderate-to-high doses of fluticasone propionate, but not with ciclesonide. [less ▲]

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See detail"Real-life" effectiveness of omalizumab in patients with severe persistent allergic asthma: The PERSIST study.
Brusselle, G.; Michils, A.; Louis, Renaud ULg et al

in Respiratory medicine (2009), 103(11), 1633-42

OBJECTIVE: To evaluate the 16- and 52-week effectiveness of add-on omalizumab treatment under real-life heterogeneity in patients, settings, and physicians in an open-label, multicenter, pharmaco ... [more ▼]

OBJECTIVE: To evaluate the 16- and 52-week effectiveness of add-on omalizumab treatment under real-life heterogeneity in patients, settings, and physicians in an open-label, multicenter, pharmaco-epidemiologic study of patients with severe persistent allergic asthma in Belgium. METHODS: Effectiveness outcomes included improvement in 2005 global initiative for asthma (GINA) classification, physician-rated global evaluation of treatment effectiveness (GETE), quality of life (Juniper asthma-related quality of life (AQLQ) and European quality of life questionnaire 5 dimensions (EQ-5D)), and severe asthma exacerbations. Patients studied included both intent-to-treat and per-protocol populations. RESULTS: The sample (n=158) had a mean age of 48.17+/-17.18 years, and a slight majority were female (53.8%). Despite being treated with high-dose inhaled corticosteroids and long-acting beta2-agonists, all patients experienced frequent symptoms and had exacerbations in the past year. At 16 weeks, >82% had good/excellent GETE (P values <0.001), >82% had an improvement in total AQLQ scores of > or =0.5 points (P<0.001), and >91% were severe exacerbation-free (P<0.001). At 52 weeks, >72% had a good/excellent GETE rating (P<0.001), >84% had improvements in total AQLQ score of > or =0.5 points (P<0.001), >56% had minimally important improvements in EQ-5D utility scores (P=0.012), and >65% were severe exacerbation-free (P<0.001). Significant reductions in healthcare utilization compared to the one year prior to treatment were noted. CONCLUSION: The PERSIST study shows better physician-rated effectiveness, greater improvements in quality of life, greater reductions in exacerbation rates, and greater reductions in healthcare utilization than previously reported in efficacy studies. Under real-life conditions, omalizumab is effective as add-on therapy in the treatment of patients with persistent severe allergic asthma. [less ▲]

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See detailExhaled nitric oxide as a marker of asthma control in smoking patients.
Michils, A.; Louis, Renaud ULg; Peche, R. et al

in European Respiratory Journal (2009), 33(6), 1295-301

Exhaled nitric oxide fraction (F(eNO)), which is a reliable marker of eosinophilic airway inflammation, is partially suppressed by tobacco smoking. Consequently, its potential as a biomarker in asthma ... [more ▼]

Exhaled nitric oxide fraction (F(eNO)), which is a reliable marker of eosinophilic airway inflammation, is partially suppressed by tobacco smoking. Consequently, its potential as a biomarker in asthma management has never been evaluated in smoking patients. In the present study, the authors tested the validity of F(eNO) to predict asthma control in this population. F(eNO) and the Asthma Control Questionnaire (ACQ) were recorded at least once in 411 nonsmoking (345 with at least two visits) and 59 smoking (51 with at least two visits) asthma patients. Despite similar mean ACQ scores (1.5 versus 1.7), F(eNO) was reduced in smoking asthmatics (18.1 ppb versus 33.7 ppb). A decrease in F(eNO) of <20% precludes asthma control improvement in nonsmoking (negative predictive value (NPV) 78%) and in smoking patients (NPV 72%). An increase in F(eNO) <30% is unlikely to be associated with deterioration in asthma control in both groups of patients (NPV = 86% and 84% in nonsmoking and smoking patients, respectively). It is concluded that, even in smokers, sequential changes in F(eNO) have a relationship with asthma control. The present study is the first to indicate that cigarette smoking does not obviate the clinical value of measuring F(eNO) in asthma among smokers. [less ▲]

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See detailL'asthme: une maladie de tout l'arbre aerien.
Tillie-Leblond, I.; Louis, Renaud ULg; Magnan, A. et al

in Revue des Maladies Respiratoires (2009), 26(8), 851-8

Inflammation and remodelling are constant features of asthma. They are present throughout the whole bronchial tree, even in the small airways (less than 2 mm). The inflammatory cell infiltrate and ... [more ▼]

Inflammation and remodelling are constant features of asthma. They are present throughout the whole bronchial tree, even in the small airways (less than 2 mm). The inflammatory cell infiltrate and structural changes are, in most cases, identical. However, in severe asthma, nocturnal asthma and fatal asthma, the cellular infiltrate in the distal airways is more intense and the number of activated cells is increased. In fatal asthma there are major alterations in the distal airways involving the smooth muscle and the bronchial epithelium, and mucus hypersecretion leading to distal airway plugging. Thus the histopathological changes in the distal airways contribute to the most severe stages of asthma and should be targeted by treatment. Currently the non-invasive tools that reflect inflammation are unable to assess these changes in the distal airways. [less ▲]

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See detailL'etude UPLIFT (Understanding Potential Long-term Impacts on Function with Tiotropium).
Corhay, Jean-Louis ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2009), 64(1), 52-7

The UPLIFT study (Understanding Potential Long-term Impacts on Function with Tiotropium) was a double-blind, randomised, international, multicentric, placebo-controlled clinical trial, investigating with ... [more ▼]

The UPLIFT study (Understanding Potential Long-term Impacts on Function with Tiotropium) was a double-blind, randomised, international, multicentric, placebo-controlled clinical trial, investigating with tiotropium (Spiriva) the change in the annual rate of decline in FEV1 in chronic obstructive pulmonary disease (COPD). Secondary end points included COPD exacerbation rate with or without hospitalisation, lung function, quality of life and mortality. 5.993 patients were randomized. In this article, we briefly describe the most important results of the study. While tiotropium did not alter the annual rate of decline in FEV1 (pre and postbronchodilatation), it improved lung function and quality of life, and reduced exacerbations and hospitalisations by comparison with control for up to 4 years. Tiotropium also reduced respiratory and cardiac morbidity. [less ▲]

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See detailMouse models of asthma: a comparison between C57BL/6 and BALB/c strains regarding bronchial responsiveness, inflammation, and cytokine production
Guéders, Maud ULg; Paulissen, Geneviève ULg; Crahay, Céline et al

in Inflammation Research (2009), 58(12), 845-54

Objective Animal models of asthma mimic major features of human disease. Since the genetic background of experimental animals might affect hyperresponsiveness and inflammation, we studied its potential ... [more ▼]

Objective Animal models of asthma mimic major features of human disease. Since the genetic background of experimental animals might affect hyperresponsiveness and inflammation, we studied its potential influence and the mechanisms leading to differences in strains. Methods We applied a mouse model of allergic asthma to BALB/c and C57BL/6 mice. Results BALB/c mice displayed greater levels of airway reactivity to methacholine than C57BL/6 mice. Moreover, BALB/c mice exhibited higher numbers of mast cells in lung tissue when compared to C57BL/6. On the contrary, eosinophil and neutrophil counts in bronchoalveolar lavage fluid (BALF) as well as peribronchial eosinophilia were greater in C57BL/6. IL (Interleukin)-4, IL-5, IL-13, and CCL11 levels measured in whole-lung extracts were higher in BALB/c, while, in sharp contrast, CCL11 and CCL5 levels were higher in BALF of C57BL/6 mice. Conclusions We observed phenotypic differences between C57BL/6 and BALB/c mice in an asthma model with different distributions of pro-inflammatory cytokines and inflammatory cells. [less ▲]

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See detailA comparison of budesonide/formoterol maintenance and reliever therapy vs. conventional best practice in asthma management.
Louis, Renaud ULg; Joos, G.; Michils, A. et al

in International Journal of Clinical Practice (2009), 63(10), 1479-88

OBJECTIVE: To study the effectiveness and safety of budesonide/formoterol (Symbicort) Maintenance And Reliever Therapy (Symbicort SMART, AstraZeneca, Sodertalje, Sweden), a simplified management approach ... [more ▼]

OBJECTIVE: To study the effectiveness and safety of budesonide/formoterol (Symbicort) Maintenance And Reliever Therapy (Symbicort SMART, AstraZeneca, Sodertalje, Sweden), a simplified management approach with one inhaler compared with conventional best practice (CBP) with multiple inhalers in patients with persistent asthma. DESIGN: Open-label randomised controlled parallel group trial, 6-month treatment. PARTICIPANTS: A total of 908 patients > or = 12 years of age, with persistent asthma receiving treatment with inhaled corticosteroids (ICS), either alone or in conjunction with long-acting beta(2)-agonist. MAIN OUTCOME MEASURES: Time to first severe asthma exacerbation and number of severe asthma exacerbations. RESULTS: No difference between groups was seen in time to first severe exacerbation (p = 0.75). Exacerbation rates were low in both groups. A total of 12 patients in the Symbicort SMART group experienced a total of 14 severe asthma exacerbations, and 19 patients in the CBP group experienced a total of 25 severe asthma exacerbations (annual rate 0.07 vs. 0.13 p = 0.09). The mean daily dose of ICS expressed in BDP equivalent was significantly lower in the Symbicort SMART group (including as-needed use) vs. in the CBP group (749 microg vs. 1059 microg; p < 0.0001). Mean scores in Asthma Control Questionnaire, 5 question version improved significantly in the SMART group compared with the CBP group (p = 0.0026). Symbicort SMART and CBP were equally well tolerated. The mean drug cost/patient/month was significantly lower for the patients in the Symbicort SMART group compared with patients receiving CBP (51.3 euros vs. 66.5 euros; p < 0.0001). CONCLUSIONS: In Belgian patients, a simplified regimen using budesonide/formoterol maintenance and reliever therapy was at least as effective at improving clinical control compared with CBP with a significantly lower ICS dose and significantly lower drug costs. [less ▲]

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See detailL'omalizumab (Xolair) dans le traitement de l'asthme allergique persistant severe.
Schleich, FLorence ULg; Manise, Maïté ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2009), 64(5-6), 313-7

L’asthme est une maladie chronique des voies aériennes. La plupart des asthmatiques ont une inflammation bronchique liée à un processus immunologique faisant intervenir les immunoglobulines E (IgE). En ... [more ▼]

L’asthme est une maladie chronique des voies aériennes. La plupart des asthmatiques ont une inflammation bronchique liée à un processus immunologique faisant intervenir les immunoglobulines E (IgE). En dépit des thérapeutiques existantes, les patients atteints d’asthme sévère ont une qualité de vie sérieusement altérée et présentent un risque élevé d’exacerbations graves pouvant parfois être fatales. L’omalizumab est un anticorps (Ac) monoclonal humanisé dirigé contre les IgE circulantes, interférant ainsi avec une des cascades moléculaires importantes dans la pathogénie de l’asthme. L’omalizumab a montré qu’il était capable d’améliorer la qualité de vie et de réduire la fréquence des exacerbations ainsi que le recours aux corticoïdes inhalés et systémiques. Selon les nouvelles recommandations de l’asthme du GINA 2006, cet agent biologique est indiqué dans l’asthme allergique persistant sévère. [less ▲]

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See detailAnalyse de l'expectoration induite dans l'asthme réfractaire
Louis, Renaud ULg; Potmans, Vincent ULg

in Presse Médicale (2008), 37(1, Pt 2), 155-9

Induction of sputum by inhalation of hypertonic or isotonic fluid makes possible the safe and noninvasive harvesting of airway cells from patients with asthma, regardless of disease severity. Analysis of ... [more ▼]

Induction of sputum by inhalation of hypertonic or isotonic fluid makes possible the safe and noninvasive harvesting of airway cells from patients with asthma, regardless of disease severity. Analysis of sputum cells has helped to identify different phenotypes of refractory asthma and shown that such asthma can be eosinophilic, neutrophilic, or both. Elevated eosinophil levels in sputum indicate a risk of exacerbation if the corticosteroid dose is reduced in stabilized patients. Surveillance of eosinophilia levels as an indicator for corticosteroid adjustment in refractory asthma makes it possible to reduce the frequency of severe exacerbations. [less ▲]

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See detailApport de l'imagerie par tomographie a emission de positons dans la pathologie pleurale. Interet de la TEP en pathologie pleurale.
Duysinx, Bernard ULg; Corhay, Jean-Louis ULg; Larock, Marie-Paule et al

in Revue des Maladies Respiratoires (2008), 25(2), 129-38

INTRODUCTION: Positron emission tomography (PET) has a clear role in oncology, particularly in thoracic disease. In the light of our experience and a revue of the literature we define precisely the role ... [more ▼]

INTRODUCTION: Positron emission tomography (PET) has a clear role in oncology, particularly in thoracic disease. In the light of our experience and a revue of the literature we define precisely the role of metabolic imaging in the diagnosis of pleural pathology. BACKGROUND: In particular PET allows characterisation of malignant pleural disease and provides prognostic information in mesothelioma. Metabolic imaging provides clinical information for the staging of pulmonary cancer, in the search for a primary tumour in metastatic pleurisy and also in the follow up of chronic or recurrent pleural pathology. CONCLUSIONS: It is justified, therefore, that PET joins the diagnostic armamentarium of pleural pathology, solid or liquid. [less ▲]

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See detailComparaison du remodelage tissulaire dans l'asthme et la BPCO.
Godinas, Laurent ULg; Duquenne, Sébastien ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2008), 63(2), 92-6

Asthma and COPD (chronic obstructive pulmonary disease) are two pulmonary obstructive diseases. It is well recognized that inflammation plays a key role in the pathogenesis of these two diseases. However ... [more ▼]

Asthma and COPD (chronic obstructive pulmonary disease) are two pulmonary obstructive diseases. It is well recognized that inflammation plays a key role in the pathogenesis of these two diseases. However, inflammation per se does not entirely account for the progressive loss in pulmonary function. It is admitted that the functional changes partly relate to airway structural alteration called remodeling. In this review we summarize the most frequent tissue abnormalities found in patients with asthma and COPD and report on the relationship between structural alterations and clinical features of the disease. [less ▲]

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See detailComment j'explore...une pathologie pleurale?
Duysinx, Bernard ULg; Corhay, Jean-Louis ULg; Nguyen Dang, Delphine ULg et al

in Revue Médicale de Liège (2008), 63(10), 615-23

Pleural involvements are common and various respiratory diseases including inflammatory, infectious, occupational, or neoplastic pathological entities...Pleural thickening and pleurisy are usual ... [more ▼]

Pleural involvements are common and various respiratory diseases including inflammatory, infectious, occupational, or neoplastic pathological entities...Pleural thickening and pleurisy are usual radiological presentation. Etiological diagnosis imposes a vast and sometimes difficult exploration and it, especially since the conventional imaging by radiology, ultrasound, scanning and nuclear magnetic resonance has no specific diagnostic criteria for pleural malignancy. The metabolic imaging by positron emission tomography (PET) has been gradually positioned in the decision-making algorithm exploration of the pleural disease due to its excellent sensitivity in the diagnosis of malignant pleurisy (88.8%-100%). The analysis of chemistry, bacteriology and cytology pleural fluid makes a significant contribution to the diagnostic approach. However, although inescapable, thoracocentesis has a diagnostic sensibility not exceeding 62%. Moreover, the sensibility of the pleural blind needle biopsies does not exceed 51%. So, thoracoscopy, more invasive, is often justified to precise pleural disease with a diagnostic sensitivity greater than 95%. Finally, despite the diagnostic arsenal available, over 10% of pleurisies remain unknown etiology. [less ▲]

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See detailLa place de l'analyse du condensat de l'air exhalé dans les maladies pulmonaires obstructives.
Renkin, C.; Corhay, Jean-Louis ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2008), 63(4), 193-8

The number of publications on the analysis of the exhaled breath condensate (EBC) has increased considerably over the last five years. The EBC is a new, noninvasive and inexpensive technique which ... [more ▼]

The number of publications on the analysis of the exhaled breath condensate (EBC) has increased considerably over the last five years. The EBC is a new, noninvasive and inexpensive technique which requires a minimum of cooperation on behalf of the patient. The condensate obtained consists of more than 99.99% of water vapour, to which are added various substances which reflect the inflammatory status of the airways. It is now especially used to characterize the inflammatory state of chronic respiratory diseases such as asthma and COPD. This article describes the technique and reviews the main data from the current literature. [less ▲]

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See detailLe cas clinique du mois. Un cas rare d'épanchement pleural unilatéral: le syndrome d'hyperstimulation des ovaires.
Barile, D.; Bataille, Yoann ULg; Duysinx, Bernard ULg et al

in Revue Médicale de Liège (2008), 63(7-8), 474-9

Ovarian hyperstimulation syndrome is the most severe iatrogenic complication of fertilization modern methods. This syndrome is characterized by a massive cystic ovarian enlargement associated with an ... [more ▼]

Ovarian hyperstimulation syndrome is the most severe iatrogenic complication of fertilization modern methods. This syndrome is characterized by a massive cystic ovarian enlargement associated with an acute body fluid shift. Ascite is the most frequent manifestation of this syndrome. In some rare cases ovarian hyperstimulation syndrome is complicated by massive unilateral pleural effusion without ascite. We describe the case of a 36 year old woman who developed a massive unilateral pleural effusion without ascite. An ovarian hyperstimulation syndrome was diagnosed. Chest tube drainage improved patient parameters and symptoms. We discuss the diagnostic approach of pleural effusions. [less ▲]

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See detailAsthme réfractaire : mécanismes sous-jacents, diagnostics et nouvelles approches thérapeutiques.
Manise, Maïté ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2008), 63(7-8), 494-499

There has been a recent increase in the prevalence of asthma worldwide. Most cases can be satisfactorily managed with a combination of inhaled corticoids and bronchodilators. However, some 10% of patients ... [more ▼]

There has been a recent increase in the prevalence of asthma worldwide. Most cases can be satisfactorily managed with a combination of inhaled corticoids and bronchodilators. However, some 10% of patients remain symptomatic despite high doses of inhaled corticosteroids and long-acting β-2 agonists. They represent a heterogeneous group consisting of those who are either undertreated, or really refractory to current available treatment. [less ▲]

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See detailLe mesotheliome: un cancer professionnel encore d'actualite!
Corhay, Jean-Louis ULg; Duysinx, Bernard ULg; Louis, Renaud ULg

in Revue Médicale de Liège (2008), 63(3), 128-35

Mesothelioma is a rare tumour, particularly aggressive, whose incidence increases because of the massive use of asbestos during the last century. Asbestos remains indeed the principal etiologic agent of ... [more ▼]

Mesothelioma is a rare tumour, particularly aggressive, whose incidence increases because of the massive use of asbestos during the last century. Asbestos remains indeed the principal etiologic agent of this cancer. In the event of mesothelioma it is advisable to seek an exposure, even of short duration, often which dates back to several decades. In certain circumstances compensation can be obtained at the Occupational Diseases Found. The renewed interest with regard to this tumour is supported by the improvement of mesothelioma management, the new imaging techniques, the new treatments and the broad diffusion of information related to the risk of developing this tumour following asbestos inhalation. [less ▲]

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See detailLa rehabilitation pulmonaire dans la bronchopneumopathie chronique obstructive.
Corhay, Jean-Louis ULg; Nguyen Dang, Delphine ULg; Schees, Pierre ULg et al

in Revue Médicale de Liège (2008), 63(11), 677-83

The current treatment of chronic obstructive pulmonary disease (COPD) patients must comprise, in addition to an optimal pharmacological treatment, a pulmonary rehabilitation, if possible multidisciplinary ... [more ▼]

The current treatment of chronic obstructive pulmonary disease (COPD) patients must comprise, in addition to an optimal pharmacological treatment, a pulmonary rehabilitation, if possible multidisciplinary, and a program of post-rehabilitation in order to maintain the outcomes. Today pulmonary rehabilitation has proved to be effective in improving dyspnoea, exercise capacity and quality of life in COPD patients, and reducing the use of health services and thus the cost. In this article we want to present pulmonary rehabilitation, its indications and results, and the way by which it is held in the CHU of Liege. [less ▲]

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See detailManifestations respiratoires de la rectocolite ulcérohémorragique et de la maladie de Crohn
Guiot, Julien; Louis, Edouard ULg; Belaiche, Jacques ULg et al

in EMC Pneumologie (2008)

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See detailPrognostic value of metabolic imaging in non-small cell lung cancers with neoplasic pleural effusion.
Duysinx, Bernard ULg; Corhay, Jean-Louis ULg; Larock, Marie-Paule ULg et al

in Nuclear Medicine Communications (2008), 29(11), 982-6

BACKGROUND: The intensity of the [F]fluorodeoxyglucose (F-FDG) uptake is an independent prognostic indicator in non-small cell lung cancer (NSCLC). We evaluate the relationship between the metabolic ... [more ▼]

BACKGROUND: The intensity of the [F]fluorodeoxyglucose (F-FDG) uptake is an independent prognostic indicator in non-small cell lung cancer (NSCLC). We evaluate the relationship between the metabolic activity of the primary and the pleurisy in T4 NSCLC. METHODS: 25 patients (16 males, nine females, mean age 63 years, performance status 1) with pathology-proven, T4 NSCLC and malignant pleurisy were included. All were treated by a platinum salt-based chemotherapy regimen. Positron emission tomography (F-FDG-PET) was performed before treatment, according to a routine procedure. Regions of interest were placed over the primary and the pleural effusion on the transaxial slice showing the highest activity. The maximum pixel standard uptake values (SUVs) were calculated. Overall survival was determined by standard Kaplan-Meier survival analysis. All patients were followed up until death. RESULTS: The median survival for the entire population was 83 days (7-988). The SUVs were higher in the primary than in the pleurisy (9.2+/-5.6 and 5.5+/-2.2, respectively). There was no correlation between primary and pleurisy SUVs (r=0.3, P>0.05). The metabolic activity of the primary tumor did not predict the outcome: the median survival was 77.5 days (range 7-988) and 87 days (19-454) in the groups with SUVs lower and higher than the median value (8.7), respectively (P>0.05). By contrast, the metabolic activity of the pleurisy was significantly correlated with the median survival, which was 196 days (40-988) when the SUVs were lower than the median value (5) and 74 days (7-170) when they were higher (P=0.0096). CONCLUSION: Among patients with T4 NSCLC, those with high metabolic activity in the pleural effusion have a dire prognosis, whereas the metabolic activity of the primary fails to predict the survival. [less ▲]

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