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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Advanced Radiotherapy Delivers Total Marrow Irradiation Treatments for Patients with Blood Cancers

By MedImaging International staff writers
Posted on 23 Aug 2011

Advanced radiotherapy can be used to treat patients with blood cancers by delivering rapidly and accurately “clinically favorable” total marrow irradiation (TMI), according to a team of noted cancer treatment experts.

The investigators presented their findings at the 2011 joint meeting of the American Association of Physicists in Medicine (AAPM) and the Canadian Organization of Medical Physicists (COMP) in Vancouver, Canada, in August 2011. Their recent study on this RapidArc radiotherapy, developed by Varian Medical Systems (Palo Alto, CA, USA), was published online in August 2011 as an article in press, ahead of publication, is slated to appear in an upcoming issue of the International Journal of Radiation Oncology*Biology*Physics.

“Compared to conventional IMRT and tomotherapy, RapidArc appears to improve on the dose distribution, in terms of normal tissue sparing, as well as on the efficiency of treatment,” said Bulent Aydogan, PhD, associate professor of medical physics at the University of Chicago (IL, USA) and the director of medical physics at the University of Illinois at Chicago (UIC; USA).

Dr. Aydogan and his collaborators planned and delivered, in their recent dosimetric feasibility study, RapidArc TMI treatments for six patients, and then compared the treatment plan parameters, including median dose, mean dose, and maximum dose, to fixed-gantry and tomotherapy plans for the same cases. They found that RapidArc generates dose distributions that are comparable to traditional intensity-modulated radiotherapy (IMRT) in terms of target coverage, but with improved normal tissue sparing.

The RapidArc treatments could also be delivered much more efficiently, requiring approximately 18 minutes once a patient was positioned for treatment. By comparison, treatment times of 45 to 50 minutes have been reported for TMI delivered using conventional IMRTand tomotherapy. “The data presented in this study demonstrate the utility of RapidArc technology in providing exceptional target coverage and normal tissue sparing even for difficult techniques like TMI,” the study authors emphasized. Based on their findings, the authors are planning to test the clinical feasibility of RapidArc for treating patients with multiple myeloma at the University of Chicago.

Radiotherapy, in combination with chemotherapy, can be employed to destroy tumor cells and suppress the immune system in preparation for a bone marrow transplant. Healthy bone marrow stem cells are then infused into the patient’s bloodstream. The new cells migrate to the bone cavities and begin producing normal blood cells.

“Historically, radiation oncologists used total body irradiation, or TBI, to prepare patients for these transplants. But TBI is not ideal, as it targets the entire body and causes too much damage to surrounding healthy tissues and organs, especially at dose levels high enough to be effective,” explained Dr. Aydogan. “Our studies have examined the feasibility of using linear accelerators to deliver IMRT to target not the whole body, but the bone marrow, and to minimize exposure of surrounding organs like the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel.”

As part of a phase I clinical trial at UIC, Dr. Aydogan and his colleagues have collaborated with Damiono Rondell, MD, professor of hematology oncology and the director of stem cell transplant program, to treat seven patients with advanced disease using intensity-modulated total marrow technique (IM-TMI). “The major drawback of the IM-TMI technique is the amount of time it takes to deliver the treatment. In this latest study, we looked specifically at RapidArc and found it to be a viable approach for accomplishing TMI within a clinically acceptable timeframe,” Dr. Aydogan said. “While patients at high risk of hematologic malignancy often do better after stem cell transplants, they still have had a high rate of disease relapse, particularly when treated using radiation-free regimens. We are hopeful that TMI will enable us to add targeted radiotherapy into the mix, for a better chance at disease-free survival with fewer complications.”

Since the technology was introduced in 2007, over 1,000 RapidArc radiotherapy-enabled systems have been installed at hospitals and clinics around the world. RapidArc treatment plans are produced using Varian’s Eclipse treatment planning software, which is cleared by the US Food and Drug Administration (FDA) for planning photon, electron, and proton beam radiotherapy for patients with malignant or benign diseases.

Related Links:
Varian Medical Systems
University of Chicago
University of Illinois at Chicago

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59 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

60 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

61 (78.916549682617): 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 (506.16264343262): SELECT fid FROM jos_deeppockets WHERE id=294736720 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736720 AND published='1' LIMIT 1

63 (51.021575927734): 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 (39.100646972656): select jos_twitters.link from jos_twitters where cat=10

65 (29.802322387695): select jos_facebook.link from jos_facebook where cat=10

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

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

68 (93.936920166016): SELECT fid FROM jos_deeppockets WHERE id=294736720 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736720 AND published='1' LIMIT 1

69 (33.855438232422): 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 (313.99726867676): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (220.06034851074): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (85.115432739258): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): 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 (28.848648071289): 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 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736720 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=294736720 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 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

105 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

109 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

110 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets 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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (505.20896911621): 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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (564.0983581543): 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 (334.9781036377): 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 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

115 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

116 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

117 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

118 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

119 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

120 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

121 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

122 (267.98248291016): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 19041.061401367): 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 (492.09594726562): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736720 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736720 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7003.0689239502): ( 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 (95.129013061523): ( 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 = 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 (36.954879760742): 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 (40.054321289062): 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 (306.84471130371): 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 (108.00361633301): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (30.994415283203): 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 (28.133392333984): 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 (596.04644775391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (437.97492980957): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (48.87580871582): SELECT name FROM jos_deeppockets WHERE id=211

138 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=211

139 (757.93266296387): 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 (609.8747253418): 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 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

142 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

143 (!!!!! 9391.0694122314): TRUNCATE TABLE jos_trademed_module

144 (94.890594482422): 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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (59.127807617188): 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=294736720 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (810.86158752441): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

149 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

150 (!!!!! 1335.1440429688): 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 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

152 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

153 (34.809112548828): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736720 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736720 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (29.087066650391): 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 (27.179718017578): 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 (29.087066650391): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (267.98248291016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

158 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736720 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736720 AND published='1' LIMIT 1

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

160 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

161 (39.100646972656): select jos_google_plus.link from jos_google_plus where cat=10

162 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

163 (273.9429473877): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1029.9682617188): insert into jos_banners_delta values (14615,'2025-06-23 00:26:35','216.73.216.120','view'),(14202,'2025-06-23 00:26:35','216.73.216.120','view'),(14203,'2025-06-23 00:26:35','216.73.216.120','view')

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