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Elderly Patients with Bone Metastases Benefit from Palliative Radiotherapy

By MedImaging International staff writers
Posted on 13 May 2013

According to a Dutch researcher, giving administering radiotherapy to older patients with painful bone metastases can significantly improve their quality of life.

The study’s findings were presented April 2013, in Geneva (Switzerland) at the 2nd Forum of the European Society for Radiotherapy and Oncology (ESTRO). With the number of elderly patients who suffer from metastatic disease on the increase due to the ageing of the population and the ability to prolong the palliative phase of cancers, this discovery has important implications for clinical practice, said Dr. Paulien Westhoff, from the department of radiotherapy at the University Medical Center Utrecht (The Netherlands).

Working with Dr. Yvette van der Linden and colleagues, Dr. Westhoff extrapolated the new findings from the Dutch Bone Metastases study, the world’s largest randomized trial examining the effectiveness of different radiotherapy fractionation schedules on the treatment of pain arising from bone metastases. The researchers assessed a subset of 227 elderly patients aged 75 and over and compared them with younger patients. Although at the beginning of the trial these patients had more physical activity impairment than younger patients, they did not rate their overall quality of life as substandard, and they demonstrated a positive response to one fraction of radiotherapy.

“The patients filled out extensive questionnaires on pain and quality of life at regular intervals,” said Dr. Westhoff. “Although we knew already that a single fraction of 8 Gy was effective in treating bone pain across the board, we were unsure as to its precise effect in the elderly, and we were pleased to be able to show that this treatment is effective in all age groups. Even though the elderly group responded slightly less well than the others to the treatment, their response was sufficient to justify the use of palliative radiotherapy in these patients.”

Reasons why the elderly group responded less well to the treatment may be related to their poorer performance status when they joined the trial and the higher percentage of male patients, who were more likely to have prostate cancer. Women were more likely to have breast cancer, which often responds better to treatment than lung or prostate cancer.

The three main groups of primary tumors in the patients studied were breast (39%), prostate (23%), and lung cancers (25%). The remaining 13% comprised a range of primary tumors, such as bladder cancer, rectal cancer, and esophageal cancer. The group was made up 54% men and 46% women. “We saw that the type of primary tumor had an effect on the response to treatment,” said Dr. Westhoff. “For example, patients with lung cancer had less chance of response than those with breast or prostate cancer. We believe that this variety in response is due to the aggressiveness of the disease and the limited ability to treat it with systemic agents.”

“Bone metastases can profoundly disrupt a patient’s life, particularly when, as is the case with many elderly, they already have other health problems. Strategies for minimizing their effect are vital to improving quality of life,” Dr. Westhoff said. “Radiotherapy departments across The Netherlands are trying to set up a prospective database to follow up the effectiveness of a number of palliative treatments. Following these encouraging results in the elderly, we intend to focus on this age group in the future,” she concluded.

President of ESTRO, Prof. Vincenzo Valentini, a radiation oncologist at the Policlinico Universitario A. Gemelli, Rome (Italy), said, “We know that the pain relief from a single fraction of radiotherapy can reduce patients’ morphine consumption. Though morphine is an important drug in the control of tumor pain, it has side effects such as nausea, constipation, and grogginess, which compromise seriously patients’ quality of life. This simple pain control strategy allows the morphine dose to be minimized, and also improves quality of life.”

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62 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

63 (138.99803161621): 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

64 (606.06002807617): SELECT fid FROM jos_deeppockets WHERE id=294746217 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746217 AND published='1' LIMIT 1

65 (62.942504882812): 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`

66 (50.067901611328): select jos_twitters.link from jos_twitters where cat=10

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

68 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

69 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

70 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294746217 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746217 AND published='1' LIMIT 1

71 (30.040740966797): 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`

72 (428.91502380371): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (282.04917907715): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (51.021575927734): 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`

75 (74.863433837891): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (!!!!! 5651.9508361816): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (107.0499420166): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (44.107437133789): 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`

92 (105.85784912109): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (140.90538024902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

107 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

108 (76.055526733398): 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=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (709.05685424805): 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=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

111 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

112 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (851.15432739258): 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=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (777.9598236084): 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

115 (511.88468933105): 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

116 (144.00482177734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

117 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

118 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

119 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

120 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

121 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

122 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

123 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

124 (!!!!! 2656.2213897705): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 60486.078262329): 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

126 (663.04206848145): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746217 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746217 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 19253.969192505): ( 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

128 (!!!!! 3436.0885620117): ( 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

129 (634.90867614746): 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

130 (70.095062255859): 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

131 (716.9246673584): 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

132 (64.13459777832): 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

133 (343.79959106445): 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

134 (226.97448730469): 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

135 (661.84997558594): 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

136 (59.843063354492): 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

137 (478.02925109863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (342.84591674805): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (38.14697265625): SELECT name FROM jos_deeppockets WHERE id=211

140 (33.855438232422): SELECT name FROM jos_deeppockets WHERE id=211

141 (538.11073303223): 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

142 (535.96496582031): 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

143 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

144 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

145 (!!!!! 18737.79296875): TRUNCATE TABLE jos_trademed_module

146 (87.976455688477): 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=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (53.882598876953): 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=294746217 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (!!!!! 2848.8636016846): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

151 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

152 (!!!!! 1188.0397796631): 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

153 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

154 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

155 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746217 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746217 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (32.901763916016): 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)

157 (29.802322387695): 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)

158 (33.140182495117): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

160 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746217 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746217 AND published='1' LIMIT 1

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

162 (28.133392333984): select jos_facebook.link from jos_facebook where cat=10

163 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

164 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

165 (303.03001403809): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1312.9711151123): insert into jos_banners_delta values (14615,'2025-08-19 09:19:18','216.73.216.0','view'),(14202,'2025-08-19 09:19:18','216.73.216.0','view'),(14203,'2025-08-19 09:19:18','216.73.216.0','view')

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