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Stereotactic Body Radiotherapy Proves Effective for Older Pancreatic Cancer Patients

By MedImaging International staff writers
Posted on 08 Oct 2013

An extremely targeted cancer radiotherapy may provide a safe and effective treatment alternative for older pancreatic cancer patients unable to undergo surgery or combined chemotherapy and radiation therapy.

Using the technology, stereotactic body radiotherapy (SBRT), the study’s findings revealed that patients lived an average if six to seven months longer following treatment with minimal side-effects even when they had other severe comorbidities such as chronic obstructive pulmonary disease (COPD), heart disease and diabetes.

Two of the patients in the study lived nearly two years. “Elderly individuals, those ages 75 and older, account for approximately 40% of patients diagnosed with pancreatic cancer,” stated study lead author Raphael Yechieli, MD, with the department of radiation oncology at Henry Ford Hospital (Detroit, MI, USA). “These patients are too ill to receive any other treatment, but with stereotactic body radiotherapy we’re able to deliver a safe and effective treatment in two weeks that can provide them with a substantial quality of life with minimal side effects.”

The study was presented at the 55nd annual American Society for Radiation Oncology (ASTRO) meeting, held September 2013 in Atlanta (GA, USA). In 2013, there will be an estimated 45,220 new cases of pancreatic cancer, and approximately 38,460 will die from the disease, according to the US National Cancer Institute (Bethesda, MD, USA). Risk factors for pancreatic cancer include smoking, diabetes, obesity, family history of the disease and pancreatitis. Most people diagnosed with the disease are older than 65.

Surgery is the only known cure for resectable pancreatic cancer, where the cancer is localized to the pancreas and it has not spread. It is estimated that only 20% of pancreatic cancer patients have their tumors present with localized disease amendable to surgical removal. A select number of those patients, however, are not candidates for surgery due to having other comorbidities such as COPD, heart disease, and diabetes. Only chemotherapy and radiation, or a combination of the two, therefore, remains available for treatment. However, for a large portion of elderly patients with localized pancreatic cancer even chemotherapy and radiation therapy are not options.

The Henry Ford study looked to determine if SBR—a method of giving radiation that can be highly targeted to the tumor, sparing the neighboring healthy tissue—was a workable alternative for this group of patients. SBRT provides a higher dose of radiation, meaning patients have fewer treatments. In this case, treatment averaged two weeks. The study included 20 patients with a median age of 83, all of whom were medically unable to tolerate surgery and/or combined chemo-radiation therapy. The majority of patients in the study (90%) received SBRT treatment at the time of diagnosis.

Seven patients reported side effects from treatment: nausea, vomiting, and fatigue. Among the patients, 13 had a recurrence of cancer and nine had cancer spread from the original tumor to distant organs or distant lymph nodes. Median overall survival was 6.7 months, and the average recurrence-free survival was 8.1 months. At six months post-treatment, 61 % of patients were alive; two patients in the study survived for nearly two years.

“National trends tell us that very few patients over the age of 75 are getting any treatment at all for pancreatic cancer due to comorbidity risks,” noted Dr. Yechieli. “So we want to push the envelope to give them a treatment option that, while not a cure, is short, effective, and safe, and has the potential to give them a good quality of life.”

The next step in this research, according to Dr. Yechieli, is to carefully follow patients after SBRT and get their direct feedback to measure post-treatment quality of life.

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63 (427.0076751709): 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 (63.180923461914): select jos_twitters.link from jos_twitters where cat=10

65 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

66 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294748550 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748550 AND published='1' LIMIT 1

69 (45.061111450195): 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 (324.96452331543): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (225.06713867188): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.908554077148): 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 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748550 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=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (31.948089599609): 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 (72.002410888672): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

105 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

106 (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 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=294748550 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (55.074691772461): 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=294748550 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=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

109 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

110 (60.081481933594): 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=294748550 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (475.88348388672): 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=294748550 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (603.91426086426): 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 (350.9521484375): 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 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

115 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

116 (100.13580322266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

117 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

118 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

120 (263.92936706543): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 23597.002029419): 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

122 (153.0647277832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

123 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

124 (575.06561279297): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748550 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748550 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 394017.93479919): ( 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 (71.048736572266): ( 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 (38.862228393555): 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

128 (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

129 (40.769577026367): 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

130 (29.802322387695): 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

131 (30.040740966797): 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

132 (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

133 (631.09397888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (521.89826965332): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (282.04917907715): SELECT name FROM jos_deeppockets WHERE id=213

136 (43.869018554688): SELECT name FROM jos_deeppockets WHERE id=213

137 (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

138 (501.15585327148): 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

139 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

140 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

141 (!!!!! 10472.059249878): TRUNCATE TABLE jos_trademed_module

142 (115.15617370605): 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=294748550 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (66.041946411133): 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=294748550 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (820.87516784668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

147 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

148 (!!!!! 1148.9391326904): 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

149 (62.227249145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

150 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

151 (53.167343139648): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748550 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748550 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (32.186508178711): 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)

153 (28.133392333984): 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)

154 (50.067901611328): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

156 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748550 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748550 AND published='1' LIMIT 1

157 (45.061111450195): select jos_twitters.link from jos_twitters where cat=10

158 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

159 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

160 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

161 (258.9225769043): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1464.84375): insert into jos_banners_delta values (14615,'2025-06-19 20:41:20','216.73.216.120','view'),(14202,'2025-06-19 20:41:20','216.73.216.120','view'),(14203,'2025-06-19 20:41:20','216.73.216.120','view')

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