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Radiotherapy After Mastectomy Helpful to Women with Breast Cancer That Metastasized to Only a Few Lymph Nodes

By MedImaging International staff writers
Posted on 03 Apr 2014

Image: A new study by Oxford scientists has found that thousands more women with breast cancer should be given radiotherapy as part of their treatment for the disease (Photo courtesy of GlowImages / Corbis).

Women whose breast cancer has metastasized to only a few lymph nodes under their arm are less likely to have a recurrence of their disease or to die from it if they have radiotherapy after mastectomy, according to new findings.

Paul McGale, PhD, a senior statistician in the Early Breast Cancer Trialists’ Collaborative Group at the Clinical Trial Service Unit (CTSU) at Oxford University (UK), presented his findings March 19, 2014,at the European Breast Cancer Conference (EBCC-9), held in Glasgow (UK), and published March 19, 2014, in the Lancet, that, until now, there has been uncertainty over whether women with early breast cancer that has spread to just one, two, or three lymph nodes under the arm gain any benefit from radiotherapy after surgery. However, his findings revealed that radiotherapy improves their risks of remaining disease-free and slashes their chance of dying from breast cancer.

“Another result from our study is that the proportional benefits of radiotherapy were similar in women regardless of whether or not they had also received chemotherapy or hormonal therapy. This is important because most women today receive these therapies. Our results suggest that women being treated today are likely also to benefit from radiotherapy if they have any positive lymph nodes,” Dr. McGale stated.

Dr. McGale analyzed results from 3,786 women in 14 randomized trials starting between 1964–1982, who had been given mastectomies along with the surgical removal of lymph nodes under the arm (axillary dissection) and who were then randomized to receive either radiotherapy to the chest wall and surrounding regions or to no radiotherapy. The women fell into three categories: those with no cancer in the lymph nodes, those with cancer in one, two or three lymph nodes, and those with cancer in four or more lymph nodes. The women were followed up for an average of just over 11 years, and data on the number of recurrences and deaths were available up to 2009.

“In 700 women in whom the pathologists could find no sign that the nodes were affected, radiotherapy did not reduce the risk of recurrence or of dying from breast cancer,” said Dr. McGale. “However, in the 1,314 women who had between one and three positive nodes, radiotherapy reduced the recurrence rate by nearly a third [32%] and the breast cancer death rate by a fifth [20%]. Giving radiotherapy to these women led to nearly 12 fewer recurrences of breast cancer per 100 women after 10 years, and eight fewer deaths per 100 women after 20 years.”

Dr. McGale discovered that the percentage declines in the recurrence and death rates in the 405 women who had only one positive node were similar to those for the women who had two or three positive nodes.

For the 1,772 women with four or more positive nodes, radiotherapy also reduced the recurrence rate (by 21%) and the breast cancer death rate (by 13%). In this instance, radiotherapy for these women led to nine fewer recurrences of breast cancer after 10 years and nine fewer deaths after 20 years per 100 women. “It is already accepted that women with four or more positive nodes benefit from radiotherapy after mastectomy, and these findings confirm this benefit,” Dr. McGale said. “However, it is for women with between one and three positive nodes where the previous evidence has been unclear.”

The benefit occurred regardless of whether the women were in trials where hormonal therapy or chemotherapy was given to all women. Sixty-five percent of women with one, two, or three positive nodes received chemotherapy, and an additional 21% with hormone-sensitive tumors received hormonal therapy.

Dr. Carolyn Taylor, FRCR, a clinical oncologist in the Early Breast Cancer Trialists’ Collaborative Group, speaking before the conference, said, “In the past, most women with many positive lymph nodes were given chemotherapy, but usually those with few positive nodes were not. In recent years, larger numbers of women with just a few positive lymph nodes have received chemotherapy, and the types of chemotherapy have changed. Also, the vast majority of women with hormone-sensitive tumors are now given hormonal therapy. We will have to wait for results from new trials to observe directly the long-term effects of modern radiotherapy in women who are given modern chemotherapy and hormonal therapy. However, it is likely that the percentage reductions in disease recurrence and breast cancer mortality from today’s radiotherapy will be at least as big as the benefits seen here.”

Dr. McGale concluded, “Since the time when the women in these trials were randomized there have been advances in radiotherapy and also in breast screening, surgery, lymph node staging, and systemic therapy. So the absolute benefits from postmastectomy radiotherapy today may be smaller than those we have reported here. But the proportional benefits from radiotherapy are likely to be at least as big.”

To study this and further follow-up on their findings, Dr. McGale, Dr. Taylor and their colleagues are inviting investigators of more recent trials comparing different radiotherapy regimens to contribute data to the Early Breast Cancer Trialists’ Group.

Prof. David Cameron, from the University of Edinburgh (UK), who is a member of the EBCC-9 executive scientific committee, commented, “These data highlight the power of combining information from individual patients recruited into a number of different clinical trials. The benefit of radiotherapy in women who needed a mastectomy for node positive breast cancer is now becoming clear; more data will emerge in a few years from the UK-led SUPREMO trial, which prospectively addresses this question for the exact same group of women that are the subject of this study.”

The 3,786 women were part of a larger group of 8,135 women in 22 randomized trials starting before 2000. During the follow-up period, 5,424 (67%) were known to have died, and the extent of surgery was known for all but 183 (2%) of the women.

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Clinical Trial Service Unit at Oxford University

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56 (512.83836364746): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1393.0797576904): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

58 (!!!!! 3757.9536437988): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

59 (!!!!! 2196.0735321045): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

60 (155.92575073242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

61 (!!!!! 4732.8472137451): 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 (742.19703674316): SELECT fid FROM jos_deeppockets WHERE id=294751597 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294751597 AND published='1' LIMIT 1

63 (452.99530029297): 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 (97.036361694336): select jos_twitters.link from jos_twitters where cat=10

65 (44.107437133789): select jos_facebook.link from jos_facebook where cat=10

66 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

67 (38.862228393555): select jos_linkedin.link from jos_linkedin where cat=10

68 (61.03515625): SELECT fid FROM jos_deeppockets WHERE id=294751597 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294751597 AND published='1' LIMIT 1

69 (68.187713623047): 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 (432.96813964844): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (357.15103149414): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (64.13459777832): 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 (85.830688476562): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (104.18891906738): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): 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 (!!!!! 3429.1744232178): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (98.943710327148): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (144.00482177734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

105 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

106 (128.03077697754): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (82.015991210938): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1263.8568878174): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

109 (149.01161193848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

110 (180.95970153809): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (646.11434936523): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (792.9801940918): 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 (658.98895263672): 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 (155.92575073242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

115 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

116 (116.10984802246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

117 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

118 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

119 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

120 (355.95893859863): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 54728.984832764): 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 (349.99847412109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

123 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

124 (!!!!! 1455.0685882568): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294751597 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294751597 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 852891.20674133): ( 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 (74.148178100586): ( 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 (40.769577026367): 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 (29.087066650391): 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 (37.908554077148): 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 (668.04885864258): 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 (55.074691772461): 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 (28.848648071289): 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 (443.93539428711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (452.99530029297): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (214.0998840332): SELECT name FROM jos_deeppockets WHERE id=213

136 (47.922134399414): SELECT name FROM jos_deeppockets WHERE id=213

137 (599.86114501953): 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 (618.93463134766): 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 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

140 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

141 (!!!!! 7341.8617248535): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1122.9515075684): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (185.96649169922): 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=294751597 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (613.92784118652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 2844.0952301025): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

147 (153.0647277832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

148 (!!!!! 1142.0249938965): 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 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

150 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

151 (48.87580871582): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294751597 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294751597 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (437.02125549316): 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 (79.154968261719): 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 (32.901763916016): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3108.024597168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

156 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294751597 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294751597 AND published='1' LIMIT 1

157 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

158 (25.98762512207): select jos_facebook.link from jos_facebook where cat=10

159 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

160 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

161 (266.07513427734): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1675.8441925049): insert into jos_banners_delta values (14615,'2025-06-19 12:44:01','216.73.216.120','view'),(14202,'2025-06-19 12:44:01','216.73.216.120','view'),(14203,'2025-06-19 12:44:01','216.73.216.120','view')

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