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Study Shows WBRT Does not Improve Metastatic Lung Cancer Outcomes

By MedImaging International staff writers
Posted on 28 Oct 2016

Whole brain radiotherapy (WBRT) adds no value to length or quality of survival in patients with metastatic non-small cell lung cancer (NSCLC), according to a new study.

Researchers at Newcastle Hospitals NHS Foundation Trust (Newcastle upon Tyne, United Kingdom), University College London (UCL, United Kingdom), and other institutions recruited 538 NSCLC adult patients with brain metastases between March 2007 and August 2014. Study participants were randomly assigned to receive best supportive care and dexamethasone, or best supportive care, dexamethasone, and WBRT (20 Gy in five daily fractions).

Benefits of treatment were measured in terms of quality adjusted life years (QALYS), which combines length and quality of life (evaluated during weekly telephone assessments). By October 2015, 536 patients had died (267 in the WBRT group and 269 in the best supportive care alone group); patients in both groups lived a similar length of time after randomization (about two months). The difference between the groups in terms of average QALYs was just 4.7 days.

Hardly any differences in steroid use or serious adverse events were reported in either group, although more episodes of drowsiness, hair loss, nausea and dry/itchy scalp were reported by WBRT patients. The researchers concluded that while WBRT may be beneficial in patients who are younger than 60 years old, it should no longer be considered standard treatment for the majority of patients with NSCLC that has spread to the brain. The study was presented at the annual European Respiratory Society meeting, held during September 2016 in London (United Kingdom).

“Whole brain radiotherapy was widely adopted into clinical practice based on the assumption it improves tumor control in patients with brain metastases. But in our lung cancer clinics, we were not seeing the improvements we had hoped for in our patients,” said lead author consultant clinical oncologist Paula Mulvenna, MD. “Survival times are poor and have hardly changed since the 1980s. What's more, the technique's toxicity can be substantial and it can damage cognitive function.”

“Whole brain radiotherapy cannot be considered as the standard treatment for all patients with brain metastases because it does not extend survival, improve quality of life, or reduce steroid use,” said senior author Professor Ruth Langley, PhD, of UCL. “In the future, potential new treatments (whether using drugs or stereotactic radiotherapy techniques) should be assessed in addition to best supportive care rather than in addition to, or in place of, whole brain radiotherapy.”

Related Links:
Newcastle Hospitals NHS Foundation Trust
University College London

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65 (!!!!! 3670.9308624268): 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 (427.0076751709): SELECT fid FROM jos_deeppockets WHERE id=294766608 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294766608 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 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

69 (25.98762512207): select jos_facebook.link from jos_facebook where cat=10

70 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

71 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

72 (33.140182495117): SELECT fid FROM jos_deeppockets WHERE id=294766608 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294766608 AND published='1' LIMIT 1

73 (27.894973754883): 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 (181.91337585449): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (243.9022064209): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (83.92333984375): 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 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (24.080276489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (39.100646972656): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (28.133392333984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (30.040740966797): 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 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (23.841857910156): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (23.841857910156): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

109 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

110 (72.956085205078): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (714.06364440918): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 3175.0202178955): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

113 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

114 (47.922134399414): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (468.01567077637): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (524.99771118164): 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 (375.98609924316): 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 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

119 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

120 (55.789947509766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

121 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

122 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

123 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

124 (155.92575073242): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 95726.013183594): 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 (563.8599395752): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

127 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

128 (!!!!! 1228.8093566895): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766608 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766608 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 1014497.0417023): ( 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 (72.956085205078): ( 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 (36.954879760742): 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 (30.040740966797): 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 (39.100646972656): 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 (27.179718017578): 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 (28.133392333984): 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 (27.179718017578): 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 (446.79641723633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (531.91184997559): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (47.922134399414): SELECT name FROM jos_deeppockets WHERE id=213

140 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=213

141 (447.98851013184): 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 (525.95138549805): 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 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

144 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

145 (!!!!! 6873.1307983398): TRUNCATE TABLE jos_trademed_module

146 (77.962875366211): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (52.928924560547): 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=294766608 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (792.9801940918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

151 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

152 (!!!!! 1073.8372802734): 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 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

154 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

155 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294766608 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294766608 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (28.848648071289): 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 (26.941299438477): 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 (29.087066650391): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

160 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294766608 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294766608 AND published='1' LIMIT 1

161 (34.093856811523): select jos_twitters.link from jos_twitters where cat=10

162 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

163 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

164 (29.802322387695): select jos_linkedin.link from jos_linkedin where cat=10

165 (233.17337036133): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1012.0868682861): insert into jos_banners_delta values (14615,'2025-05-01 02:27:42','3.147.103.209','view'),(14202,'2025-05-01 02:27:42','3.147.103.209','view'),(14203,'2025-05-01 02:27:42','3.147.103.209','view')

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