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Proton Therapy Provides Safe, Long-Term Treatment for Hodgkin Lymphoma

By MedImaging International staff writers
Posted on 07 Jul 2014

Image: An axial CT scan slice through the heart (red) of a patient with Hodgkin lymphoma involving the mediastinum. On the left is the X-ray plan and on the right is the proton plan. The dark blue line in both represents the tumor and target area for the radiation. The green line represents the volume of the body receiving 95% of the total prescribed dose of radiation, while the light blue line reflects the volume of the body receiving 10% of the total prescribed radiation dose. As is apparent, with conventional radiation (left), the X-rays deposit more radiation in the heart and breasts than the proton plan. In fact, the proton plan reduced the mean dose to the heart by more than 50% and the mean dose to the breast by 70%. For this reason, it’s believed that Hodgkin lymphoma patients will have a much lower risk of heart disease and second malignancy with proton therapy than what’s been observed in the past with conventional radiation therapy (Photo courtesy of the University of Florida Proton Therapy Institute).

In spite of various successes in treating patients with Hodgkin lymphoma, many patients suffer from the late effects of radiation therapy and chemotherapy treatment, including the possible onset of breast cancer or heart disease.

A study by the University of Florida (UF) Proton Therapy Institute (Jacksonville, USA) revealed that the use of proton therapy following chemotherapy in patients with Hodgkin lymphoma has a success rate similar to the conventional treatments with a reduction of radiation outside of the target area, or “involved-node,” potentially reducing the risk of late effects caused by radiation.

The phase II study was published June 11, 2014, in the online edition of the International Journal of Radiation Oncology Biology Physics and adds to the increasing evidence supporting the use of proton Radiotherapy for positive long-term treatment outcomes. Several retrospective dosimetry studies, measuring the radiation dose in tissue resulting from exposure to direct and/or indirect radiation, have reported the advantages of proton therapy in Hodgkin lymphoma as a way of cutting the radiation dose to the organs at risk, such as the lungs, heart, and breast. However, this study is the first of its kind to track the proton therapy treatment findings on patients with Hodgkin lymphoma.

The research monitored 15 patients between September 2009 and June 2013 with newly diagnosed Hodgkin lymphoma as they received involved-node proton therapy (INPT), which specifically targets initially involved lymph node(s) containing the Hodgkin lymphoma, after completing chemotherapy. Further, the study evaluated the radiation dose in the surrounding healthy tissue as a result of proton therapy compared with conventional treatments, called intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT).

The data show a three-year relapse-free rate of 93% and a three-year event-free rate of 87%. Furthermore, no patients developed grade three or higher toxicity during follow-up. “All 15 patients derived benefits from using proton therapy. The results show that the use of protons, as opposed to similar conventional photon therapy, reduced the risk of long-term side effects by reducing or eliminating radiation doses to healthy tissue without compromising the cure rate,” said lead researcher Bradford S. Hoppe, MD, a radiation oncologist from the UF Proton Therapy Institute, and assistant professor in the University of Florida College of Medicine department of radiation oncology. “Three years after the [US] National Comprehensive Cancer Network guidelines endorsed the use of proton therapy, this study reinforces proton therapy as a safe alternative to the more conventional forms of radiation,” Dr. Hoppe concluded.

Related Links:
University of Florida Proton Therapy Institute

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64 (42.915344238281): select jos_twitters.link from jos_twitters where cat=10

65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294753385 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294753385 AND published='1' LIMIT 1

69 (30.994415283203): 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 (234.12704467773): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (226.97448730469): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (36.954879760742): 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 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.007995605469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (27.894973754883): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): 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 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.809112548828): 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 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

105 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

106 (51.021575927734): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.968460083008): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

109 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

110 (51.975250244141): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (454.90264892578): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (526.90505981445): 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 (313.04359436035): 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 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

115 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

116 (55.789947509766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

117 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

118 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

120 (268.93615722656): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 18692.016601562): 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 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

123 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

124 (470.16143798828): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753385 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753385 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 744648.93341064): ( 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 (!!!!! 627332.92579651): ( 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 (365.01884460449): 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 (41.961669921875): 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 (234.12704467773): 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 (35.04753112793): 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 (174.99923706055): 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 (33.140182495117): 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 (346.18377685547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (327.11029052734): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (118.01719665527): SELECT name FROM jos_deeppockets WHERE id=213

136 (68.902969360352): SELECT name FROM jos_deeppockets WHERE id=213

137 (415.08674621582): 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 (398.87428283691): 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 (972.98622131348): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

140 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

141 (!!!!! 6393.9094543457): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 2555.1319122314): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (510.93101501465): 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=294753385 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (288.96331787109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

147 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

148 (!!!!! 1031.1603546143): 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 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

150 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

151 (434.16023254395): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753385 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753385 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (42.200088500977): 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 (27.894973754883): 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 (28.848648071289): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 2862.9302978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

156 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753385 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753385 AND published='1' LIMIT 1

157 (113.01040649414): select jos_twitters.link from jos_twitters where cat=10

158 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

159 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

160 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

161 (242.94853210449): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 6890.0585174561): insert into jos_banners_delta values (14615,'2025-06-19 04:54:18','216.73.216.120','view'),(14202,'2025-06-19 04:54:18','216.73.216.120','view'),(14203,'2025-06-19 04:54:18','216.73.216.120','view')

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