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Progress Achieved in Reducing Radiation for Pediatric Hodgkin Lymphoma Treatment
By MedImaging International staff writers Posted on 05 Jul 2012
Investigators have succeeded in keeping cure rates high for young patients with favorable-risk Hodgkin lymphoma while reducing their risks of serious side effects of radiotherapy.
A multicenter trial revealed that nearly half of young patients with early-stage Hodgkin lymphoma can be cured without undergoing either irradiation or intensive chemotherapy that would leave them at risk for second cancers, infertility, heart, and other complications later.
St. Jude Children’s Research Hospital (Memphis, TN, USA) investigators led this multi-institution study, which concentrated on pediatric Hodgkin lymphoma patients without widespread disease or symptoms such as weight loss, fever, and night sweats. The findings will likely stimulate efforts to identify patients with even more advanced disease whose cancer could be effectively treated with less irradiation.
“This study adds to evidence that it is possible to omit radiation even in patients treated with a less intense chemotherapy regimen and still achieve excellent long-term survival,” said Monika Metzger, MD, an associate member of the St. Jude department of oncology. She is the first author of the research, which is published in the June 27, 2012, edition of the Journal of the American Medical Association (JAMA).
“These results will help push efforts to further adapt therapies based on a patient’s disease risk factors and early response to treatment with the goal of eliminating radiation for as many patients as possible,” stated Dr. Metzger. She noted that the findings point to the possibility that elderly Hodgkin patients with similarly limited disease and who are less able to tolerate intensive chemotherapy may also be candidates for this minimal treatment approach.
For years, radiation has been a part of Hodgkin lymphoma treatment in children and adults. In children, radiation and chemotherapy have helped push long-term survival rates for patients with favorable-risk disease to better than 90%. But radiation leaves patients susceptible to secondary tumors and other serious problems later. By the 1990s, research was underway to identify patients who could be cured without radiation.
Hodgkin is found in 850 to 900 children and adolescents yearly and accounts for an estimated 6% of all childhood cancers. The disease strikes the lymph system, which includes the lymph nodes, tonsils, and other immune system components.
This study involved 88 patients whose cancer had metastasized to less than three lymph node groups and surrounding tissue. None of the patients reported fever, weight loss, or other symptoms also associated with a worse outcome. Approximately one-third of young Hodgkin lymphoma patients fall into this favorable risk category. The patients were treated between March 2000, and December 2008, at St. Jude; Stanford University Medical Center (Stanford, CA, USA); Dana-Farber Cancer Institute and Massachusetts General Hospital (both in Boston, MA, USA); and Maine Medical Center (Portland, ME, USA). One patient withdrew early and was not included in the results.
The patients all received four rounds of chemotherapy with the drugs vinblastine, Adriamycin, methotrexate and prednisone, a combination known as VAMP (vincristine, amethopterin [methotrexate], 6-MP, and prednisone). Unlike some other chemotherapy drugs used to treat Hodgkin lymphoma, none of these drugs is linked to second cancers or infertility. One, Adriamycin, belongs to a family of drugs that can lead to heart damage, but at much higher cumulative doses.
Radiation was recommended for patients whose tumors had not shrunk at least 75% following two rounds of chemotherapy. Those patients received low-dose irradiation of 25.5 grays to the tumor and surrounding tissue.
For patients with a favorable initial response to chemotherapy, omitting radiation had no impact on their survival either two years or five years after their diagnosis. Those patients fared no worse than patients who received radiation therapy after the opening rounds of chemotherapy resulted in only a partial response. All patients followed for at least five years were still alive regardless of their initial treatment. More than 88% of the five-year survivors were cancer-free. Patients in both treatment groups were equally likely to enjoy that status.
Cancer returned in 11 patients, including five not initially treated with radiation. The recurrence was successfully treated with chemotherapy and low-dose irradiation. Four patients who received irradiation during their treatment received high-dose chemotherapy and bone marrow transplants when their cancer returned. One patient was successfully treated with a more intensive chemotherapy and radiation combination than the one that initially worked, but that patient did not undergo a bone marrow transplant. Another patient relapsed with a form of lymphoma known as non-Hodgkin lymphoma. In spite of treatment, that patient later died of the disease.
Dr. Metzger reported that the findings suggest that for a subgroup of Hodgkin lymphoma patients this therapeutic regimen may not be appropriate. These are patients with nodular lymphocyte predominant Hodgkin. Of the five patients in the chemotherapy-only group who relapsed, four had this subtype.
Related Links: St. Jude Children’s Research Hospital
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AND id != 294743310
AND metakey != 'aacc'
ORDER BY `ordering`73
(54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 174
(30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 175
(28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 176
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 177
(!!!!! 1020.1930999756): SELECT show_live FROM jos_com_show_setting LIMIT 178
(41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 179
(28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 180
(29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 181
(26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 182
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 183
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 184
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 185
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 186
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 187
(45.061111450195): SELECT fid FROM jos_deeppockets
WHERE cat=10
AND id=294741426
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 188
(29.802322387695): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741426 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 189
(33.855438232422): 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
(!!!!! 1575.9468078613): SELECT show_live FROM jos_com_show_setting LIMIT 191
(62.942504882812): SELECT show_live FROM jos_com_show_setting LIMIT 192
(30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 193
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 194
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 195
(28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 196
(32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 197
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 198
(27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 199
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1100
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1101
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1102
(26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1103
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1104
(!!!!! 1075.0293731689): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1105
(75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1106
(57.220458984375): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1107
(422.00088500977): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1108
(162.83988952637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1109
(56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1110
(53.167343139648): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1111
(484.94338989258): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1112
(759.12475585938): 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 1113
(!!!!! 2671.0033416748): 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 1114
(123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1115
(70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1116
(86.784362792969): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1117
(56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1118
(72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1119
(53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1120
(76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1121
(58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1122
(341.17698669434): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`123
(!!!!! 58799.028396606): 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
7124
(714.06364440918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741426 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741426 AND type='deeppockets_item' AND published='1' LIMIT 1125
(!!!!! 24071.216583252): (
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
3126
(66.041946411133): (
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
3127
(379.80079650879): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1128
(53.167343139648): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1129
(226.02081298828): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1130
(46.014785766602): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1131
(170.94612121582): 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 1132
(42.915344238281): 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 1133
(151.8726348877): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1134
(41.007995605469): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1135
(461.10153198242): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294741426
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1136
(375.98609924316): SELECT *
FROM jos_deeppockets_archive
WHERE 1=1
AND id=294741426
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1137
(225.06713867188): SELECT name FROM jos_deeppockets WHERE id=213138
(48.87580871582): SELECT name FROM jos_deeppockets WHERE id=213139
(805.85479736328): 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((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3140
(652.79006958008): SELECT *,
DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
FROM jos_events
WHERE state=1
AND publish_up > NOW()
and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3141
(735.04447937012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1142
(68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1143
(!!!!! 19947.052001953): TRUNCATE TABLE jos_trademed_module144
(!!!!! 1478.910446167): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1145
(88.930130004883): 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=294741426
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1146
(516.89147949219): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294741426
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1147
(249.86267089844): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294741426
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1148
(415.08674621582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1149
(165.93933105469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1150
(!!!!! 2611.1602783203): 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 6151
(535.01129150391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1152
(76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1153
(324.01084899902): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741426 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741426 AND type='deeppockets_item' AND published='1' LIMIT 1154
(854.9690246582): 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
(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)156
(303.03001403809): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1157
(319.00405883789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1158
(72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741426 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741426 AND published='1'
LIMIT 1159
(458.0020904541): select jos_twitters.link from jos_twitters where cat=10160
(414.84832763672): select jos_facebook.link from jos_facebook where cat=10161
(51.021575927734): select jos_google_plus.link from jos_google_plus where cat=10162
(40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10163
(589.84756469727): update jos_bannersmanager_banner
set impmade=impmade+1
where id in(14615,14202,14203)164
(!!!!! 1200.9143829346): insert into jos_banners_delta values (14615,'2025-09-27 04:22:56','216.73.216.151','view'),(14202,'2025-09-27 04:22:56','216.73.216.151','view'),(14203,'2025-09-27 04:22:56','216.73.216.151','view')
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