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Stereotactic Body Radiotherapy Effective for Treatment of Inoperable Non-Small-Cell Lung Cancer

By MedImaging International staff writers
Posted on 16 Oct 2012

A radiosurgical approach that destroys lung and other tumors using precisely-shaped, high dose X-ray beams has been shown to be effective for treating early-stage, high-risk, non-small-cell lung cancer in patients who cannot be operated on, and new research has been designed to assess the usefulness of this approach.

In the September 2012 issue the Journal of Thoracic and Cardiovascular Surgery, an article was published that summarized the objectives of an ongoing phase III study comparing stereotactic body radiotherapy (SBRT) with surgery for the treatment of early-stage, high-risk, operable non-small cell lung cancer. This group of patients is frequently referred to as being medically inoperable. SBRT is also known as stereotactic ablative body radiotherapy (SABR) for its unique radiobiologic features that can initiate increased tumor response and high humor control rates.

Standard-risk operable patients with lung cancer are usually treated with surgery to remove the affected lobe (lobar resection). Patients who cannot tolerate complete removal of a lobe, but who are still deemed healthy enough to undergo general anesthesia, frequently referred to as “high-risk, operable” patients, are typically treated with sublobar resection.

“Several investigators have suggested that SBRT might be equally effective for these high-risk operable patients,” said Dr. Robert Timmerman, study cochair. “We set up this randomized study to compare SBRT, which is a noninvasive therapy, with surgery. We’ll be looking at patients’ overall, disease-free, and regional recurrence-free survival rates three years after treatment, and also comparing adverse events and post-treatment quality of life measures.”

“The primary objective of the study is to determine whether patients treated with SBRT have three-year overall survival rates that are no more than 10% less than patients treated with sublobar resection,” said Hiran C. Fernando, MD, study chairman. “Although it is certainly attractive to patients to have a less invasive therapy, with lower risks, we need to know whether this translates into better cancer control or survival.”

Sponsored by the US National Cancer Institute (NCI; Bethesda, MD, USA), the study is being managed by the Alliance for Clinical Trials in Oncology (Chicago, IL, USA), an NCI-sponsored research cooperative that was formed in March 2011 from the merger of the American College of Surgeons Oncology Group (ACOSOG), Cancer and Leukemia Group B (CALGB), and the North Central Cancer Treatment Group (NCCTG). The study plans to compile 420 patients over a five-year period.

In September 2012, Varian Medical Systems (Palo Alto, CA, USA) became the exclusive corporate supporter of this study, specifically to support institutions, as well as the overall conduct of the trial by the Alliance for Clinical Trials in Oncology. Varian TrueBeam and Trilogy medical linear accelerator systems are included in the techniques that can be used to perform SBRT procedures.

“We are hoping that more cancer treatment centers will complete the credentialing process and participate in the study, so that we can accrue a sufficient number of patients in a reasonable timeframe,” concluded Dr. Fernando. “We believe that this study will help us make better decisions about when to use surgery and when to use SBRT, so that surgeons and radiation oncologists can work together more effectively to counsel patients regarding the risks and benefits of each approach.”

Related Links:
US National Cancer Institute
Alliance for Clinical Trials in Oncology
Varian Medical Systems

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62 (686.8839263916): SELECT fid FROM jos_deeppockets WHERE id=294742957 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294742957 AND published='1' LIMIT 1

63 (85.115432739258): 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 (78.916549682617): select jos_twitters.link from jos_twitters where cat=10

65 (58.174133300781): select jos_facebook.link from jos_facebook where cat=10

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

67 (35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10

68 (83.92333984375): SELECT fid FROM jos_deeppockets WHERE id=294742957 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294742957 AND published='1' LIMIT 1

69 (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`

70 (373.84033203125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (318.05038452148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (57.93571472168): 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 (!!!!! 3304.9583435059): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (69.856643676758): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (52.928924560547): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (35.04753112793): 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 (!!!!! 2230.167388916): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (57.220458984375): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2394.9146270752): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

105 (142.09747314453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

106 (!!!!! 3912.9257202148): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (707.86476135254): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 5841.0167694092): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

109 (172.13821411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

110 (84.161758422852): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 2759.9334716797): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1342.0581817627): 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 (!!!!! 7667.064666748): 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 (696.89750671387): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

115 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

116 (!!!!! 1815.0806427002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

117 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

118 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

119 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

120 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

121 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

122 (445.84274291992): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 57485.103607178): 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 (821.82884216309): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742957 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742957 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 24572.134017944): ( 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 (54.836273193359): ( 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 (286.10229492188): 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 (!!!!! 2837.1810913086): 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 (560.99891662598): 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 (92.029571533203): 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 (538.82598876953): 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 (38.862228393555): 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 (197.17216491699): 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 (542.16384887695): 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 (825.88195800781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (356.91261291504): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (592.94700622559): SELECT name FROM jos_deeppockets WHERE id=211

138 (47.922134399414): SELECT name FROM jos_deeppockets WHERE id=211

139 (!!!!! 1154.899597168): 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 (698.08959960938): 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 (!!!!! 2682.9242706299): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

142 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

143 (!!!!! 22155.046463013): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 6922.0066070557): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 7938.1465911865): 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=294742957 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 7534.9807739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 8017.0631408691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 7632.0171356201): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

149 (!!!!! 7992.9828643799): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

150 (!!!!! 5153.8944244385): 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 (!!!!! 2645.0157165527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

152 (265.83671569824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

153 (377.89344787598): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742957 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742957 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (143.05114746094): 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 (36.001205444336): 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 (416.99409484863): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (419.13986206055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

158 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742957 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742957 AND published='1' LIMIT 1

159 (771.99935913086): select jos_twitters.link from jos_twitters where cat=10

160 (51.975250244141): select jos_facebook.link from jos_facebook where cat=10

161 (!!!!! 3451.1089324951): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 7937.9081726074): select jos_linkedin.link from jos_linkedin where cat=10

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