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Highly Targeted Irradiation Works as Well as Whole Breast Radiotherapy in Early Stage Breast Cancer

By MedImaging International staff writers
Posted on 05 Jun 2012

Hungarian researchers have revealed that by using a concentrated, highly targeted dose of radiation to the breast has equally good results as irradiating the whole area, with no adverse effects on survival and a much better cosmetic outcome.

Reporting the 10-year results of a randomized trial, Prof. Csaba Polgar, MD, director of the Centre for Radiotherapy, National Institute of Oncology (Budapest, Hungary) told the World Congress of Brachytherapy, which was held in in Barcelona (Spain) during May 9-13, 2012, that he believes accelerated partial breast irradiation (APBI) could be offered to many more breast cancer patients, resulting in fewer side effects and major cost savings to healthcare systems.

The Budapest trial was the first randomized study to compare the efficacy and side effects of conventional whole breast irradiation with APBI using multicatheter brachytherapy. This technique consists of inserting multiple plastic catheters into the tumor bed after breast conserving surgery. The catheters are inserted under local or general anesthesia, according to the wishes of the patient. The radiation source is then loaded into them to deliver a highly concentrated dose to the exact region of the excised tumor--the region most likely to develop a local recurrence of the cancer. By using APBI, the major part of the healthy breast tissue does not receive radiation.

“In a group of 258 women who had had breast-conserving surgery, we found that, at a median follow-up time of just over 10 years, the rate of local recurrence--the cancer coming back in the same place--was 5.9% in the APBI group and 5.1% in the group who received whole breast irradiation,” said Prof. Polgár. “There was no significant difference in overall survival, cancer-specific survival, and disease free survival between the two groups. However, the differences in cosmetic outcome were striking--81% in the APBI group had good-to-excellent results as opposed to 63% of those who received whole breast irradiation.”

An additional benefit of APBI is that treatment time can be shortened. As opposed to whole breast irradiation, where a course of treatment typically takes five weeks (five treatments per week), APBI can be performed in four to five days. “We believe that the results of our trial will encourage more patients to choose APBI, particularly those who may now be inclined to refuse radiotherapy because of the logistical difficulties involved--having to travel long distances over a period of six weeks can be a major problem for some patients,” Prof. Polgár noted.

Fewer than 10% of early stage breast-cancer patients currently receive APBI in Europe, and in some countries, it is still considered an investigational treatment. In other parts of the world, for example, in the United States, it has already been accepted into general practice for the treatment of selected low-risk patients.

“Our trial has shown that it is possible to use a faster and more focused treatment without compromising survival. It is a little like comparing a total mastectomy with a lumpectomy--we have found that we can improve cosmetic outcomes, lessen side effects, and achieve greater patient satisfaction with a less invasive and more cost-effective technique. Other multicenter trials of APBI are currently underway, and we believe that these are likely to give further support to our findings,” Prof. Polgár concluded.

Dr. Christine Haie-Meder, a radiation oncologist at the Institut Gustave Roussy (Villejuif, France) and chairperson of the congress, said, “We know that all the patients with breast cancer do not need whole breast irradiation. Especially in elderly patients, the treatment, when limited to partial breast irradiation, can be significantly shortened. This study is important because, within the frame of a randomized trial with a 10-year follow-up, it shows that in selected patients, partial breast irradiation gives as good results as whole breast irradiation with the same recurrence rate, but with significantly better cosmetic results.”

Brachytherapy is a type of internal radiotherapy, which involves putting solid radioactive material close to, or inside, the tumor. This gives a high dose of radiotherapy directly to the tumor but only a low dose to normal tissues.

The World Congress of Brachytherapy was held in parallel with the 31st conference of the European Society for Radiotherapy and Oncology (ESTRO 31).

Related Links:
Hungarian National Institute of Oncology

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59 (175.95291137695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

60 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

61 (!!!!! 2210.1402282715): 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 (576.97296142578): SELECT fid FROM jos_deeppockets WHERE id=294740976 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294740976 AND published='1' LIMIT 1

63 (394.10591125488): 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 (77.009201049805): select jos_twitters.link from jos_twitters where cat=10

65 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

66 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

68 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE id=294740976 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294740976 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 (298.97689819336): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740976 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=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (41.007995605469): 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 (197.17216491699): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 3938.1980895996): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (133.99124145508): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (113.96408081055): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (42.200088500977): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (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`

90 (106.0962677002): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (241.04118347168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

105 (!!!!! 1138.9255523682): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

106 (117.06352233887): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (767.94624328613): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (835.89553833008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

109 (613.92784118652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

110 (81.062316894531): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (590.08598327637): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (906.94427490234): 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 (743.86596679688): 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 (141.85905456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

115 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

116 (101.80473327637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

117 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

118 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

119 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

120 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

121 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

122 (481.12869262695): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 62591.075897217): 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 (!!!!! 1003.0269622803): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740976 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740976 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 23239.850997925): ( 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 (89.168548583984): ( 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 (309.94415283203): 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 (53.167343139648): 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 (252.00843811035): 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 (51.021575927734): 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 (188.82751464844): 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 (51.021575927734): 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 (214.81513977051): 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 (46.968460083008): 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 (499.01008605957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (380.9928894043): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (201.94053649902): SELECT name FROM jos_deeppockets WHERE id=211

138 (51.021575927734): SELECT name FROM jos_deeppockets WHERE id=211

139 (777.00614929199): 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 (782.96661376953): 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 (120.87821960449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

142 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

143 (!!!!! 16145.944595337): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 3556.0131072998): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (128.98445129395): 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=294740976 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (639.91546630859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

149 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

150 (!!!!! 1602.8881072998): 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 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

152 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

153 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740976 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740976 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (33.855438232422): 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 (30.040740966797): 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 (34.093856811523): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 2661.9434356689): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

158 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740976 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740976 AND published='1' LIMIT 1

159 (74.863433837891): select jos_twitters.link from jos_twitters where cat=10

160 (45.061111450195): select jos_facebook.link from jos_facebook where cat=10

161 (43.153762817383): select jos_google_plus.link from jos_google_plus where cat=10

162 (39.100646972656): select jos_linkedin.link from jos_linkedin where cat=10

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