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SBRT Improves NSCLC Survival Rates in Elderly Patients

By MedImaging International staff writers
Posted on 14 Oct 2016

Survival rates of elderly patients with early-stage non-small cell lung cancer (NSCLC) have risen dramatically over the past decade, concurrent with the increasing adoption of stereotactic body radiation therapy (SBRT), according to a new study.

Researchers at Houston Methodist Hospital (HMH; Houston, TX, USA), Baylor College of Medicine (Houston, TX, USA), and other institutions reviewed the medical records of 62,213 patients age 60 and above who were diagnosed with stage I NSCLC between 2004 and 2012, as extracted from the U.S. Surveillance, Epidemiology, and End Results (SEER) database. The patients were grouped into five-year subsets (60-64; 65-69; 70-74; 75-79; 80-84; 85-89; and 90 and older), and overall survival (OS) and lung cancer-specific survival rates were then calculated to draw population-based comparisons between SBRT and surgery alone.

The results showed that from 2004 to 2012--the years in which adoption of SBRT in community practice became widespread--the OS rate at 23 months following SBRT alone rose from 39 to 58%; OS rates for surgery alone rose from 79 to 84%. In the same time period, cancer-specific survival increased from 48 to 72% of patients who received SBRT alone, and from 87 to 91% of patients receiving surgery alone. Cancer-specific survival rates remained stable for patients who received neither surgery nor radiation.

Analysis revealed that the use of surgery to treat stage I NSCLC declined with age. While 81% of patients age 60-64 underwent surgery, only 47% of patients age 80 or older were able to undergo surgery. The use of SBRT, conversely, rose with increasing age, ranging from 11% of patients age 60-64 to 39% of patients age 90 or above. The number of patients receiving no treatment also increased, from 7 to 40% for the youngest and oldest elderly patient cohorts in the study. The study was presented at the 58th annual meeting of the American Society for Radiation Oncology (ASTRO), held during September 2016 in Boston (MA, USA).

“While survival rates remain highest for surgical candidates, this study demonstrates both clear benefits from SBRT for nonsurgical NSCLC patients and that outcomes following radiation therapy have improved at a more accelerated pace over the past decade than those for any other therapeutic approach,” said senior author Andrew M. Farach, MD, of Baylor College of Medicine. “With continued adoption of SBRT in community cancer centers, it is our hope that more patients will receive curative SBRT and the number of patients left untreated based on age or medical comorbidity will continue to fall.”

SBRT is emerging as an attractive option for treating cancers in the lung, head and neck, prostate, liver and other disease sites, with the objective of increasing local control of the target lesion while limiting dose to nearby critical structures and normal tissue. Requirements include precise localization of the target lesion in the treatment planning process; accounting for tumor motion due to respiration or other changes in the body; highly conformal dose distribution to the target volume, including a steep dose gradient to minimize radiation to surrounding healthy tissue; and image-guidance at the time of dose delivery for verification and adjustment of the target localization.

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Houston Methodist Hospital
Baylor College of Medicine

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63 (164.98565673828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

64 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

65 (154.97207641602): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

66 (749.11117553711): SELECT fid FROM jos_deeppockets WHERE id=294766424 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294766424 AND published='1' LIMIT 1

67 (66.995620727539): 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 (89.168548583984): select jos_twitters.link from jos_twitters where cat=10

69 (44.822692871094): select jos_facebook.link from jos_facebook where cat=10

70 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

71 (41.007995605469): select jos_linkedin.link from jos_linkedin where cat=10

72 (61.03515625): SELECT fid FROM jos_deeppockets WHERE id=294766424 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294766424 AND published='1' LIMIT 1

73 (51.021575927734): 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 (489.95018005371): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (413.89465332031): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (69.856643676758): 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 (75.101852416992): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (67.949295043945): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766424 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 (79.870223999023): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

109 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

110 (89.883804321289): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (75.817108154297): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

113 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

114 (73.909759521484): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (665.90309143066): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (697.13592529297): 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 (522.85194396973): 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 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

119 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

120 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

121 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

122 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

123 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

124 (371.93298339844): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 20444.869995117): 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 (149.96528625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

127 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

128 (590.08598327637): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766424 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766424 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 1184868.0973053): ( 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 (!!!!! 749365.09132385): ( 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 (118.01719665527): 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 (48.87580871582): 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 (92.029571533203): 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 (49.829483032227): 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 (55.074691772461): 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 (717.1630859375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (622.98774719238): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (64.13459777832): SELECT name FROM jos_deeppockets WHERE id=213

140 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=213

141 (706.91108703613): 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 (701.904296875): 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 (!!!!! 1589.0598297119): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

144 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

145 (!!!!! 12769.937515259): TRUNCATE TABLE jos_trademed_module

146 (117.77877807617): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (813.96102905273): 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=294766424 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (611.0668182373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

151 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

152 (!!!!! 1619.1005706787): 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 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

154 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

155 (614.88151550293): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766424 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766424 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (62.942504882812): 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 (46.968460083008): 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 (64.13459777832): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (211.95411682129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

160 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766424 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766424 AND published='1' LIMIT 1

161 (65.088272094727): select jos_twitters.link from jos_twitters where cat=10

162 (40.054321289062): select jos_facebook.link from jos_facebook where cat=10

163 (39.100646972656): select jos_google_plus.link from jos_google_plus where cat=10

164 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

165 (385.04600524902): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1896.858215332): insert into jos_banners_delta values (14615,'2025-05-01 09:44:03','3.14.247.147','view'),(14202,'2025-05-01 09:44:03','3.14.247.147','view'),(14203,'2025-05-01 09:44:03','3.14.247.147','view')

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