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Lower Total Radiotherapy Dose with Fewer Larger Treatments as Effective for Breast Cancer Patients

By MedImaging staff writers
Posted on 17 Apr 2008

A lower total dose of radiotherapy, delivered in fewer, larger treatments has been demonstrated to be as effective as the international standard of a higher total dose delivered over a longer time to treat women with early breast cancer.

According to a study published in the March 2008 issue of the journal Lancet and Lancet Oncology, this confirms long-held beliefs of cancer specialists who have been using shorter schedules for many years. Nearly 4,500 women took part in the Standardization of Breast Radiotherapy (START) trials coordinated by the Clinical Trials and Statistics Unit at the Institute of Cancer Research (London, UK) and funded by Cancer Research UK (London, UK), the Medical Research Council (London, UK), and the UK Department of Health. Just under half the women received the international standard radiotherapy delivering 25 treatments, treating five times per week over five weeks. The remainder of study participants received a lower total dose given in fewer, larger treatments in either three or five weeks.

Researchers then compared the rate of cancer recurrence in the treated breast combined with the effects of the treatment on surrounding healthy breast tissues. After a median follow-up of five to six years, the rate of recurrence in the breast remained very low for patients in each of the treatment groups studied. The rate of side effects were low overall, and no higher in women receiving the revised treatment than those receiving the international standard of 25 treatments. The results suggested that a lower total dose given in fewer larger treatments is as safe and effective in treating early stage breast cancer as the longer standard schedule.

Shorter radiotherapy treatments have been used in the United Kingdom for many years with promising results but this is the first systematic and consistent evaluation to compare the longer international treatment and the shorter revised UK treatment.

The benefits of fewer sessions of radiotherapy to patients with early breast cancer mean fewer trips to the hospital for treatment, which then mean less disruption in a daily routine. Reducing the number of trips to the hospital is also financially beneficial to patients. The results also offer new insights into how breast cancer cells handle radiotherapy damage to the DNA, suggesting how treatments might be improved further.

Lead investigator, Prof. John Yarnold, from The Institute of Cancer Research, said, "These trials represent a successful 10-year collaboration between cancer specialists, and several thousand women motivated to help others by volunteering for research. The results suggest that a high total dose given in 25 small treatments is no better than simpler schedules using fewer exposures to a lower total dose. Shorter therapies giving fewer, larger treatments are obviously convenient for patients. The results support the current use of shorter schedules in the UK and in other countries.”

Sir Leszek Borysiewicz, chief executive of the Medical Research council, said, "This research will help to refine the way we treat women who are battling this disease. The research will lead to fewer sessions of radiotherapy. This work will help patients with early breast cancer. They'll have to go to hospital for treatment less often which means fewer trips to cancer units. But the results will also help us to understand this disease better at a genetic level so we can make treatments even better in the future.”

Related Links:
Institute of Cancer Research
Cancer Research UK
Medical Research Council

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63 (!!!!! 7551.1932373047): 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 (!!!!! 7438.8980865479): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 11558.055877686): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 4230.9761047363): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 7946.9680786133): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 7839.9181365967): SELECT fid FROM jos_deeppockets WHERE id=278590000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=278590000 AND published='1' LIMIT 1

69 (!!!!! 7898.0922698975): 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 (!!!!! 4181.8618774414): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 6644.0105438232): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 5030.1551818848): 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 (!!!!! 4061.9373321533): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (213.8614654541): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (693.08280944824): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (202.89421081543): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 1518.9647674561): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (106.0962677002): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (520.94459533691): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 3420.1145172119): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 4413.1278991699): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (!!!!! 4028.0818939209): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (!!!!! 5623.1021881104): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (!!!!! 2516.9849395752): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 3217.9355621338): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (!!!!! 1274.1088867188): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 3897.9053497314): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (49.114227294922): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): 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 (422.95455932617): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (205.99365234375): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (174.99923706055): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (174.04556274414): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (236.03439331055): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (133.99124145508): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3787.9943847656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

105 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

106 (250.10108947754): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (605.10635375977): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1581.1920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

109 (!!!!! 1428.8425445557): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

110 (226.02081298828): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (597.95379638672): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 4256.9637298584): 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 (622.03407287598): 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 (577.92663574219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

115 (164.98565673828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

116 (!!!!! 1595.0202941895): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

117 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

118 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

119 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

120 (545.02487182617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

121 (781.05926513672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

122 (!!!!! 2701.997756958): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 73600.053787231): 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 (483.03604125977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278590000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278590000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (65.088272094727): ( 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 (37.908554077148): ( 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 (36.954879760742): 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 (47.922134399414): 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 (516.89147949219): 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 (42.915344238281): 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 (36.001205444336): 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 (190.97328186035): 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 (35.04753112793): 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 (669.00253295898): 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 (!!!!! 1705.8849334717): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 1116.0373687744): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (56.028366088867): SELECT name FROM jos_deeppockets WHERE id=213

138 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=213

139 (617.02728271484): 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 (!!!!! 1186.8476867676): 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 (!!!!! 1813.1732940674): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

142 (674.00932312012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

143 (!!!!! 13092.994689941): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 4891.1571502686): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (191.92695617676): 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=278590000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2269.0296173096): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1147.0317840576): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

149 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

150 (!!!!! 1670.1221466064): 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 (!!!!! 1041.8891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

152 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

153 (!!!!! 1372.0989227295): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278590000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278590000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (61.03515625): 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 (47.922134399414): 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 (321.86508178711): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (906.94427490234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

158 (579.833984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278590000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278590000 AND published='1' LIMIT 1

159 (386.95335388184): select jos_twitters.link from jos_twitters where cat=10

160 (39.100646972656): select jos_facebook.link from jos_facebook where cat=10

161 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

162 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

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