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Proton Radiotherapy Bests Standard Radiotherapy

By MedImaging International staff writers
Posted on 17 Feb 2016

Proton beam therapy (PBT) to treat medulloblastoma in pediatric patients appears to be as safe as conventional treatment and offers similar survival rates, according to a new study.

Researchers at Massachusetts General Hospital (MGH; Boston, MA, USA) and Brigham and Women's Hospital (Boston, AM, USA) conducted a non-randomized, open-label, phase 2 trial involving 59 patients (aged 3–21 years) with medulloblastoma to assess late complications, acute side-effects, and survival associated with PBT. All patients underwent craniospinal irradiation of 18–36 Gy radiobiological equivalents (GyRBE), followed by a boost dose. The primary outcome was cumulative incidence of ototoxicity at three years; secondary outcomes were neuroendocrine toxic effects and neurocognitive toxic effects, as assessed by intention-to-treat.

The results showed that three years after treatment, progression-free survival was at 83%, and at five years, progression-free survival was 80%; 12% of patients had serious hearing loss, which rose to 16% at five years. Processing speed and verbal comprehension were also affected, but perceptual reasoning and working memory were not. At five years, 55% had problems with the neuroendocrine system, with growth hormone being the most commonly affected. On the other hand, the researchers found no cardiac, pulmonary, or gastrointestinal toxic effects, which are common in patients treated with photon radiotherapy. The study was published on January 29, 2016, in the Lancet Oncology.

“Proton radiotherapy resulted in acceptable toxicity and had similar survival outcomes to those noted with conventional radiotherapy, suggesting that the use of the treatment may be an alternative to photon-based treatments,” concluded lead author Torunn Yock, MD, and colleagues of the MGH Proton Center. “Although there remain some effects of treatment on hearing, endocrine, and neurocognitive outcomes, particularly in younger patients, other late effects common in photon-treated patients were absent.”

PBT is a precise form of radiotherapy that uses charged particles instead of X-rays to deliver a dose of radiotherapy more precisely and with minimal damage to surrounding tissue. Evidence is growing that protons can be effective in treating a number of cancers, in particular children and young people with brain tumors, for whom PBT appears to produce fewer side effects such as secondary cancers, growth deformity, hearing loss, and learning difficulties.

Related Links:
Massachusetts General Hospital
Brigham and Women's Hospital

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66 (610.8283996582): SELECT fid FROM jos_deeppockets WHERE id=294762812 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294762812 AND published='1' LIMIT 1

67 (351.90582275391): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

68 (119.92454528809): select jos_twitters.link from jos_twitters where cat=10

69 (39.815902709961): select jos_facebook.link from jos_facebook where cat=10

70 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

71 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

72 (54.836273193359): SELECT fid FROM jos_deeppockets WHERE id=294762812 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294762812 AND published='1' LIMIT 1

73 (91.075897216797): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

74 (301.12266540527): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (442.0280456543): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (78.916549682617): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (74.863433837891): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 4486.083984375): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (133.03756713867): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (147.10426330566): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (42.915344238281): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

109 (!!!!! 4735.9466552734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

110 (102.99682617188): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (67.949295043945): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (143.05114746094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

113 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

114 (157.11784362793): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (671.8635559082): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (943.89915466309): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (580.78765869141): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (168.80035400391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

119 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

120 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

121 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

122 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

123 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

124 (391.96014404297): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 54980.039596558): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (153.0647277832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

127 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

128 (828.02772521973): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762812 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762812 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 819983.00552368): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (!!!!! 858109.95101929): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (105.14259338379): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (67.949295043945): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (54.121017456055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (663.04206848145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (514.03045654297): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (424.86190795898): SELECT name FROM jos_deeppockets WHERE id=213

140 (47.922134399414): SELECT name FROM jos_deeppockets WHERE id=213

141 (775.09880065918): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (568.15147399902): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

144 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

145 (!!!!! 11050.939559937): TRUNCATE TABLE jos_trademed_module

146 (143.05114746094): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (75.101852416992): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762812 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (794.88754272461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (121.11663818359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

151 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

152 (!!!!! 1609.0869903564): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

154 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

155 (97.036361694336): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762812 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762812 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (56.028366088867): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

157 (49.829483032227): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

158 (66.041946411133): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

160 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762812 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762812 AND published='1' LIMIT 1

161 (74.863433837891): select jos_twitters.link from jos_twitters where cat=10

162 (39.815902709961): select jos_facebook.link from jos_facebook where cat=10

163 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

164 (34.809112548828): select jos_linkedin.link from jos_linkedin where cat=10

165 (355.00526428223): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1338.005065918): insert into jos_banners_delta values (14615,'2025-05-02 06:15:07','18.191.28.161','view'),(14202,'2025-05-02 06:15:07','18.191.28.161','view'),(14203,'2025-05-02 06:15:07','18.191.28.161','view')

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