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Tumor-Tracking Technology Reduces Side Effects from Radiation for Prostate Cancer

By MedImaging International staff writers
Posted on 17 Mar 2010

A prospective, multisite study is the first outcomes-based study to evaluate the quality of life of high-dose intensity-modulated radiotherapy (IMRT) to the prostate with tightly contoured treatment technically described as "reduced treatment margins.” The study findings demonstrate that the use of tumor tracking technology during high dose external beam radiation for prostate cancer resulted in a significant reduction in rectal and urinary treatment-related side effects.

Calypso Medical Technologies, Inc. (Seattle, WA, USA) is a developer of the targeting technology used for precise real-time tracking of tumor targets, reported the study results, published in the online in February 2010 in the journal Urology. "This is the first comparative study to show that margin reduction in prostate cancer radiation therapy has clinically significant and measurable benefits in decreasing acute toxicity and short-term side effects. By reducing acute toxicity, we hope these patients may also experience a significant reduction of long-term side effects,” said Dr. Constantine Mantz, radiation oncologist at 21st Century Oncology (Cape Coral, FL, USA) and lead investigator of the study. "When prostate cancer patients evaluate treatment options, their objective is to select the therapeutic approach that will cure the cancer while allowing them to remain as fully functional as possible. The Calypso system, which enables physicians to deliver increased doses of radiation directly to the tumor, while sparing the surrounding healthy organs from exposure, is fundamental to our overall approach of treating prostate cancer.”

Organ motion is prevalent, variable, and unpredictable during radiation therapy and can be caused by normal physiologic events such as digestion, breathing or coughing. Tracking and responding to this motion is critical for radiation treatments because internal movement of the organ and tumor increases the likelihood that the radiation beam will miss the intended target and deliver radiation to the surrounding healthy tissue, causing side effects. To ensure that the treatment target stays within the path of the radiation beam, physicians typically increase the planning treatment volume (PTV) margin, which is defined as the area of healthy tissue surrounding the prostate tumor that is exposed to the radiation beam. With real-time tracking of the target using the Calypso technology, physicians are able to decrease the PTV margins, thereby subjecting less healthy tissue to radiation, according to the investigators.

Researchers compared the AIM study group of 64 patients to 153 patients in a comparator study published in the New England Journal of Medicine (NEJM) in 2008. Beacon electromagnetic transponders, which are the size of a grain of rice and emit signals that track the location of the prostate with submillimeter accuracy, were implanted into the prostates of the AIM study group. This level of precision allowed researchers to reduce the PTV margin while at the same time increase the radiation dose to 81 Gy to more effectively treat the cancer. Comparator patients were treated using standard institutional processes and larger PTV margins.

In both groups, patient-reported quality of life was assessed before and after the completion of radiation therapy using a clinically validated questionnaire, the Expanded Prostate Cancer Index Composite (EPIC) that measures several different domains of the patient's health. Changes in scores were compared between the AIM study and comparator groups while accounting for important patient and cancer characteristics. The AIM study group experienced considerably fewer side effects associated with bowel urgency and frequency, fecal incontinence, and urinary irritation than the comparator group. AIM patients not receiving hormonal therapy also experienced smaller, yet statistically significant advantages over the comparator group in terms of sexual function.

"Without any tracking at all, I used to use a 10-mm treatment margin; with Calypso, I use a 3-mm treatment margin and the AIM study results demonstrate an improvement in patient-reported quality of life,” said Howard M. Sandler, M.D., chair of radiation oncology at Cedars-Sinai Medical Center's Samuel Oschin Comprehensive Cancer Institute (Los Angeles, CA, USA), lead author on the AIM study and investigator in the NEJM comparator study. "Of all the technologies that are available, the Calypso system is the only one that can do real-time tracking as well as localization and provides an important advantage in terms of keeping the radiation beam on the prostate.”

The Calypso system, with its GPS for the Body technology, provides real-time tumor tracking during radiation treatment. Calypso Medical's proprietary technology utilizes miniature Beacon transponders implanted in the diseased organ to provide accurate, precise, continuous information about the tumor target's position during external beam radiation therapy. The Calypso system is cleared by the U.S. Food and Drug Administration (FDA) for use in radiation therapy for the prostate and prostatic bed; however, the technology is designed for body-wide applications.

"This study validates our long-held belief that the ability to track tumor motion in real-time is a critical component in adapting radiation therapy, as it assures the clinician and the patient that radiation is delivered to the cancerous tissue while sparing healthy tissue and decreasing unwanted side effects,” said Kenneth Russell, M.D., medical director at Calypso Medical. "We are excited about these results as we move forward in expanding the reach of our technology into applications where the tumors experience higher velocity movement.”

Related Links:
Calypso Medical Technologies
21st Century Oncology

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57 (!!!!! 1599.0734100342): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

58 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

59 (147.10426330566): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

60 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

61 (115.87142944336): 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 (612.97416687012): SELECT fid FROM jos_deeppockets WHERE id=294728516 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294728516 AND published='1' LIMIT 1

63 (52.928924560547): 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=211 ORDER BY `ordering`

64 (80.108642578125): select jos_twitters.link from jos_twitters where cat=10

65 (43.153762817383): select jos_facebook.link from jos_facebook where cat=10

66 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (42.915344238281): SELECT fid FROM jos_deeppockets WHERE id=294728516 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294728516 AND published='1' LIMIT 1

69 (46.014785766602): 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=211 ORDER BY `ordering`

70 (447.03483581543): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (360.01205444336): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (54.121017456055): 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 (76.770782470703): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (73.909759521484): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.961669921875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (62.942504882812): 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 (64.849853515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

105 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

106 (77.962875366211): 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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (124.21607971191): 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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

109 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

110 (68.902969360352): 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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (680.92346191406): 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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (657.08160400391): 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 (445.84274291992): 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 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

115 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

116 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

117 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

118 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

119 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

120 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

121 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

122 (396.0132598877): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 22279.977798462): 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 (540.01808166504): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728516 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728516 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 8764.0285491943): ( 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 (79.870223999023): ( 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 (41.007995605469): 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 (30.040740966797): 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 (49.114227294922): 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 (30.040740966797): 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 (338.79280090332): 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 (66.041946411133): 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 (35.04753112793): 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 (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

135 (568.15147399902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (388.14544677734): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=211

138 (30.040740966797): SELECT name FROM jos_deeppockets WHERE id=211

139 (555.99212646484): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (567.19779968262): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

142 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

143 (!!!!! 8654.1175842285): TRUNCATE TABLE jos_trademed_module

144 (99.897384643555): 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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (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=294728516 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1009.9411010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

149 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

150 (!!!!! 1324.8920440674): 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 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

152 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

153 (72.002410888672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294728516 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294728516 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (47.922134399414): 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=211 or channel_id is null)

155 (35.04753112793): 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=211 or channel_id is null)

156 (38.14697265625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (212.9077911377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

158 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294728516 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294728516 AND published='1' LIMIT 1

159 (43.869018554688): select jos_twitters.link from jos_twitters where cat=10

160 (43.869018554688): select jos_facebook.link from jos_facebook where cat=10

161 (38.14697265625): select jos_google_plus.link from jos_google_plus where cat=10

162 (32.901763916016): select jos_linkedin.link from jos_linkedin where cat=10

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