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Stereostactic Image-Guided Radiotherapy Benefits High-Risk Patients

By MedImaging staff writers
Posted on 07 Jan 2008

Image: The ExacTrac X-Ray 6D System for image-guided radiotherapy (Photo courtesy of BrainLAB).

A new radiotherapy system that combines high-tech imaging with precision tumor-targeting capability is helping cancer specialists treat patients. Those with medically inoperable tumors, at high-risk for surgery, or who do not want surgical treatment may benefit most from the ExacTrac X-ray six-dimensional (6D) system for image-guided radiotherapy. The system adds to patient options for stereotactic body radiation therapy (SBRT), a technique that features high radiation doses with pinpoint precision to tumors.

Most of the patients treated with this technology at the Stony Brook University Medical Center (Stony Brook, NY, USA) have experienced few or no side effects when treated for lung cancer or other forms of disease with this radiotherapy system. The power and precision of the system also allows for short therapeutic duration. Treatments take one-to-two weeks to complete and require only three or four doses. Conventional beam therapy frequently lasts many weeks and many doses. BrainLAB (Feldkirchen, Germany) is the developer of the ExacTrac system.

"We have had substantial success in treating patients with tumors of the lung, brain, spine, head and neck, and prostate with the ExacTrac system,” stated Allen G. Meek, M.D., chair of the department of radiation oncology, indicating that the system has become an integral part of the department's therapeutic options after several months in operation. "ExacTrac enables us to deliver treatment to some previously irradiated sites without damaging critical structures like the spinal cord,” explained Dr. Meek. "This greatly improves our ability to treat some inoperable tumors and cancers that spread from primary sites.”

"Scarring is considerably reduced with this new modality because it delivers top-of-the-line aiming capability using low-dose beams from many directions that converge on the same target to deliver a high dose,” said Thomas Bilfinger, M.D., professor of surgery and co-director of the Lung Cancer Evaluation Center at Stoney Brook. "Less scarring leads to fewer losses of functioning tissue over time, which can be particularly beneficial for lung cancer patients.”

The treatment procedure with the ExacTrac System consists of four key steps: (1) An automated and image-guided patient positioning system, based on the patient's form and location of tumor, is used for the initial patient set-up; (2) high-resolution X-rays pinpoint internal tumor sites, verifying the location across six dimensions and calculating key reference points for delivery of radiotherapy; (3) a remote control system corrects any initial patient set-up errors; and (4) the system tracks any patient movement that may affect treatment during the entire session.

"The imaging component is critical to the process,” added Bong S. Kim, M.D., assistant professor of clinical radiation oncology. "We can position the patient within two millimeters precision, which maximizes radiation treatment directly to the tumor.”

For SBRT to be effective, optimal patient immobilization is required. The ExacTrac system uses the most sophisticated technology available for ensuring that the patient is positioned for treatment as accurately as possible. The computerized BodyFix system guides the overall system by way of a non-invasive vacuum activated immobilization and fixation unit. This device limits movement caused by patient breathing, as well as tumor movement.

Related Links:
Stony Brook University Medical Center
BrainLAB

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63 (!!!!! 2148.1513977051): 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`

64 (!!!!! 4238.8439178467): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 2067.0890808105): select jos_facebook.link from jos_facebook where cat=10

66 (91.075897216797): select jos_google_plus.link from jos_google_plus where cat=10

67 (45.061111450195): select jos_linkedin.link from jos_linkedin where cat=10

68 (818.96781921387): SELECT fid FROM jos_deeppockets WHERE id=267170000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=267170000 AND published='1' LIMIT 1

69 (83.208084106445): 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`

70 (478.02925109863): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (405.07316589355): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (66.041946411133): 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`

73 (641.1075592041): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (126.12342834473): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (222.92137145996): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (262.97569274902): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (141.14379882812): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (241.99485778809): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (185.01281738281): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (187.15858459473): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 3024.1012573242): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (108.95729064941): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (61.03515625): 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`

90 (790.83442687988): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (391.00646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (!!!!! 1123.9051818848): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (!!!!! 2732.9921722412): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (197.8874206543): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (293.97010803223): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1629.114151001): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

105 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

106 (96.797943115234): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (901.93748474121): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3263.9503479004): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

109 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

110 (814.91470336914): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 4653.9306640625): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1360.8932495117): 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

113 (!!!!! 1281.0230255127): 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

114 (!!!!! 3632.7838897705): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

115 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

116 (!!!!! 1162.052154541): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

117 (642.06123352051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

118 (!!!!! 1518.9647674561): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

119 (823.02093505859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

120 (!!!!! 1240.0150299072): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

121 (447.03483581543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

122 (530.00450134277): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 54911.851882935): 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

124 (!!!!! 1102.2090911865): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=267170000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=267170000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 18636.94190979): ( 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

126 (52.928924560547): ( 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

127 (344.99168395996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (651.83639526367): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (470.16143798828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (406.02684020996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (56.982040405273): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (38.14697265625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1344.9192047119): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (659.94262695312): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (310.89782714844): SELECT name FROM jos_deeppockets WHERE id=213

138 (509.97734069824): SELECT name FROM jos_deeppockets WHERE id=213

139 (813.00735473633): 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

140 (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

141 (351.90582275391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

142 (330.92498779297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

143 (!!!!! 7277.9655456543): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 11340.856552124): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 1078.1288146973): 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=267170000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1385.9272003174): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (971.07887268066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

149 (401.97372436523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

150 (!!!!! 2951.8604278564): 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

151 (!!!!! 2280.9505462646): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

152 (478.98292541504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

153 (414.13307189941): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=267170000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=267170000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 2834.0816497803): 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)

155 (487.08915710449): 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)

156 (643.96858215332): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 2008.9149475098): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

158 (288.00964355469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=267170000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=267170000 AND published='1' LIMIT 1

159 (!!!!! 4425.048828125): select jos_twitters.link from jos_twitters where cat=10

160 (797.03330993652): select jos_facebook.link from jos_facebook where cat=10

161 (56.028366088867): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 1524.9252319336): select jos_linkedin.link from jos_linkedin where cat=10

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