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Single Dose Radiation During Surgery Helps Early Stage Breast Cancer Patients Forgo Longer Radiation Course

By MedImaging International staff writers
Posted on 19 Jul 2012

A hospital in New York City (NY, USA) is offering early stage breast cancer patients a new breakthrough in radiotherapy technology, a novel radiation treatment delivered in one dose at the time of surgery.

Women with early stage breast cancer frequently undergo breast-conserving surgery (lumpectomy), to take out a cancerous tumor. Lumpectomy is followed by daily doses of radiation therapy to the entire breast, typically lasting six to seven consecutive weeks.

“Intrabeam radiotherapy may be an effective alternative to a six to seven week regimen following surgery for select patients because it allows us to precisely target any remaining cancer cells right inside the tumor bed, where the tumor is most likely to recur,” said Dr. Mary Katherine Hayes, clinical director of radiation oncology at New York-Presbyterian Hospital/Weill Cornell Medical Center and associate professor of clinical radiology and radiation oncology at Weill Cornell Medical College (New York, NY, USA). The Intrabeam technology was developed by Carl Zeiss (Jena, Germany).

Right after removal of the tumor, while the patient is still on the operating table, the Intrabeam’s applicator’s small, cylindrical tip is positioned inside the tumor cavity to deliver a superficial dose of radiation for 20-30 minutes, while limiting exposure to healthy neighboring tissue and organs. After the applicator is removed, the surgical incision is closed.

“Our ability to use this radiation technique in such a timely manner may add to its effectiveness since the area in need of treatment can be directly visualized at the moment the tumor is removed,” noted Dr. Alexander J. Swistel, attending breast surgeon at the Iris Cantor Women’s Health Center at New York-Presbyterian/Weill Cornell Medical Center and associate professor of clinical surgery at Weill Cornell Medical College.

This alternative to traditional full-breast radiation therapy is in step with the hospital’s longstanding practice of customizing partial breast cancer treatments to a growing number of patients with a small, early stage tumor. Eliminating an additional six to seven weeks of radiation therapy is particularly convenient for patients who do not live in close proximity to a hospital or an established radiation therapy facility.

A 10-year randomized phase III clinical trial of intraoperative therapy for breast cancer found that for selected patients, single dose radiotherapy delivered at the time of surgery yielded the same results as conventional full breast radiation delivered over several weeks. The TARGIT-A Trial, published in the Lancet in July 2010, examined only the Intrabeam system and was the largest randomized clinical trial conducted in this field, more than 2,000 women in multiple countries were enrolled.

While Intrabeam is restricted to a select group of patients with a very small tumor, if tissue samples removed during surgery are ascertained to be more aggressive than early tests revealed, the patient will still be able to undergo traditional full-breast radiation. However, the patient would not need to undergo the final five-day phase of conventional treatment, called boost therapy, which targets the tumor bed with external radiation.

“We are very excited to provide this cutting edge treatment to patients with early staged breast cancer. This is a part of our effort toward personalized cancer care,” remarked Dr. K.S. Clifford Chao, a radiation-oncologist-in-chief of New York-Presbyterian Hospital and professor of Weill Cornell Medical Center.

Related Links:
New York-Presbyterian Hospital/Weill Cornell Medical Center
Carl Zeiss

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61 (93.936920166016): 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

62 (468.01567077637): SELECT fid FROM jos_deeppockets WHERE id=294741684 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294741684 AND published='1' LIMIT 1

63 (292.06275939941): 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 (51.975250244141): select jos_twitters.link from jos_twitters where cat=10

65 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

66 (29.802322387695): select jos_google_plus.link from jos_google_plus where cat=10

67 (27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294741684 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294741684 AND published='1' LIMIT 1

69 (31.948089599609): 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 (301.12266540527): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (277.04238891602): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (38.14697265625): 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 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (32.901763916016): 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 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

105 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

106 (50.067901611328): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.014785766602): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

109 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

110 (62.942504882812): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (445.84274291992): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (543.11752319336): 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 (344.99168395996): 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 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

116 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

117 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

118 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

119 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

120 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

121 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

122 (272.03559875488): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 19596.099853516): 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 (462.05520629883): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741684 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741684 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7031.9175720215): ( 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 (68.902969360352): ( 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 (37.908554077148): 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 (29.087066650391): 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 (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

130 (29.087066650391): 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 (285.14862060547): 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 (33.855438232422): 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 (30.040740966797): 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 (26.941299438477): 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 (406.98051452637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (293.01643371582): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (216.00723266602): SELECT name FROM jos_deeppockets WHERE id=213

138 (37.193298339844): SELECT name FROM jos_deeppockets WHERE id=213

139 (523.09036254883): 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 (427.9613494873): 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 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

142 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

143 (!!!!! 9288.0725860596): TRUNCATE TABLE jos_trademed_module

144 (84.877014160156): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (56.982040405273): 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=294741684 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (778.9134979248): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

149 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

150 (!!!!! 1055.0022125244): 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 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

152 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

153 (38.14697265625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294741684 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294741684 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (30.040740966797): 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 (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)

156 (28.133392333984): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

158 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294741684 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294741684 AND published='1' LIMIT 1

159 (37.908554077148): select jos_twitters.link from jos_twitters where cat=10

160 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

161 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

162 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

163 (236.03439331055): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1007.080078125): insert into jos_banners_delta values (14615,'2025-06-20 21:06:14','216.73.216.120','view'),(14202,'2025-06-20 21:06:14','216.73.216.120','view'),(14203,'2025-06-20 21:06:14','216.73.216.120','view')

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