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Results for Intraoperative Radiotherapy for Breast Cancer Similar to Conventional Radiotherapy

By MedImaging International staff writers
Posted on 23 Dec 2013

Image: Intrabeam IORT is delivered during the lumpectomy procedure, immediately following tumor removal (left). After the surgeon has removed the tumor, the radiation oncologist positions the Intrabeam applicator in the area of the breast where the tumor was located (right) (Photo courtesy of Zeiss).

Image: Low energy radiation is delivered locally to the targeted tissue in the tumor bed, minimizing healthy tissue exposure to radiation (left). After 20-30 minutes of radiotherapy, the applicator is removed and the surgeon then closes the incision (right) (photo courtesy of Zeiss).

A new clinical trial for breast cancer revealed that a single fraction of targeted intraoperative radiotherapy (TARGIT) delivered with the Zeiss Intrabeam at time of lumpectomy is as good as conventional external beam radiation (EBRT) delivered over three to six weeks after breast conserving surgery for a select group of patients.

The study’s findings were published December 3, 2013, in the Lancet. “The most important benefit of TARGIT for a woman with breast cancer is that it allows her to complete her entire local treatment at the time of her operation, with lower toxicity to the breast, the heart, and other organs. Our research supports the use of TARGIT concurrent with lumpectomy, provided patients are selected carefully, and should allow patients and their clinicians to make a more informed choice about individualizing their treatment, saving time, money, breasts, and lives,” said Prof. Jayant S. Vaidya, MD, PhD, FRCS, a consultant surgeon at the Whittington, Royal Free and University College London Hospitals (UK), and part of the international TARGIT investigators group.

Since 1998, the international TARGIT research group has investigated whether radiotherapy targeted to the tumor bed at the time of surgery can reduce the risk of recurrence in early breast cancer as effectively as the traditional three to six week EBRT. Typically, whole-breast EBRT is given after breast-conserving surgery (lumpectomy) to reduce the risk of recurrence of cancer in the breast and of breast cancer mortality. EBRT typically is administered over a period of three to six weeks requiring patients to receive treatment at radiotherapy centers for 20–30 days. In some instances, women suitable for breast conserving surgery, but living far from a radiotherapy center and unable to attend daily postsurgical treatments may even undergo mastectomy as an option.

In the TARGIT approach, during surgery after removal of the tumor, the affected tissue in the tumor bed is irradiated from within the breast using the Zeiss Intrabeam. The TARGIT study results show that targeted intraoperative radiotherapy delivered with Zeiss Intrabeam (Oberkochen, Germany) can reduce the risk of recurrence of the cancer as effectively as a traditional three- to six-week course of whole breast irradiation in selected women with invasive ductal carcinoma.

The TARGIT-A trial has been to date the largest multicenter randomized clinical trial for intraoperative radiotherapy (IORT) in the field of partial breast irradiation, with 3,451 patients in 33 international centers from the United States, Europe, and Australia. The TARGIT-A trial followed an individualized risk-adapted strategy, meaning, that patients who had received TARGIT at the time of surgery showed in the final pathology additional unanticipated risk factors, received supplemental EBRT, which occurred for about 15% of the patients.

The five-year results for local recurrence and the first analysis of overall survival of the TARGIT-A trial have now been reported. Comparing TARGIT with EBRT the difference in five-year local recurrence between the two treatments was less than 2.5% and therefore considered “non-inferior” to standard EBRT (daily doses for three to six weeks) in treating the cancer. Overall mortality was 3.9% with TARGIT and 5.3% with EBRT, due to fewer deaths from cardiovascular causes and other cancers.

Based on statistical comparison of breast cancer recurrence, number of deaths and side effects of TARGIT versus EBRT the authors concluded, “TARGIT concurrent with lumpectomy within a risk-adapted approach should be considered as an option for eligible patients with breast cancer carefully selected as per the TARGIT-A trial protocol.”

“We commend the international TARGIT group pioneered by Prof. Jayant Vaidya and Prof. Michael Baum for this outstanding research on this new treatment option that can benefit many breast cancer patients. The TARGIT group’s research will further enhance adoption by radiation oncologists and breast surgeons worldwide and will broaden the application of our Zeiss Intrabeam for this new option in the fight against cancer,” stated Dr. Ludwin Monz, president and CEO of Carl Zeiss Meditec, AG.

Related Links:
University College London Hospitals
Carl Zeiss

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57 (!!!!! 5038.9766693115): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

58 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

59 (146.15058898926): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

60 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

61 (!!!!! 4420.0420379639): 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 (816.10679626465): SELECT fid FROM jos_deeppockets WHERE id=294749818 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294749818 AND published='1' LIMIT 1

63 (495.91064453125): 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 (79.154968261719): select jos_twitters.link from jos_twitters where cat=10

65 (102.04315185547): select jos_facebook.link from jos_facebook where cat=10

66 (57.93571472168): select jos_google_plus.link from jos_google_plus where cat=10

67 (43.869018554688): select jos_linkedin.link from jos_linkedin where cat=10

68 (59.843063354492): SELECT fid FROM jos_deeppockets WHERE id=294749818 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294749818 AND published='1' LIMIT 1

69 (47.922134399414): 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 (467.77725219727): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (286.10229492188): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (46.014785766602): 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 (77.962875366211): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (!!!!! 1768.1121826172): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (93.936920166016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.961669921875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (48.87580871582): 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 (!!!!! 1383.0661773682): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (78.916549682617): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

105 (!!!!! 2439.9757385254): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

106 (97.990036010742): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (694.03648376465): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

109 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

110 (51.021575927734): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (492.81120300293): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1614.0937805176): 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 (519.99092102051): 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 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

116 (!!!!! 1236.9155883789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

117 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

118 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

119 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

120 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

121 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

122 (!!!!! 1905.9181213379): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 56452.989578247): 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 (948.19068908691): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294749818 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294749818 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 19196.033477783): ( 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 (76.770782470703): ( 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 (66.041946411133): 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 (55.074691772461): 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 (689.02969360352): 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 (68.187713623047): 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 (571.96617126465): 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 (67.949295043945): 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 (247.95532226562): 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 (63.180923461914): 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 (605.82160949707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (365.01884460449): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (128.98445129395): SELECT name FROM jos_deeppockets WHERE id=211

138 (38.14697265625): SELECT name FROM jos_deeppockets WHERE id=211

139 (591.99333190918): 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 (622.98774719238): 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 (!!!!! 8315.0863647461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

142 (!!!!! 1312.9711151123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

143 (!!!!! 15650.987625122): TRUNCATE TABLE jos_trademed_module

144 (190.01960754395): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (146.15058898926): 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=294749818 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (439.88227844238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 2033.9488983154): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (114.91775512695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

149 (290.1554107666): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

150 (!!!!! 3835.916519165): 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 (!!!!! 3697.8721618652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

152 (565.0520324707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

153 (!!!!! 9294.9867248535): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294749818 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294749818 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 1149.8928070068): 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 (!!!!! 2927.0648956299): 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 (!!!!! 1442.9092407227): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 1829.1473388672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

158 (823.02093505859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294749818 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294749818 AND published='1' LIMIT 1

159 (!!!!! 3774.1661071777): select jos_twitters.link from jos_twitters where cat=10

160 (!!!!! 1303.9112091064): select jos_facebook.link from jos_facebook where cat=10

161 (!!!!! 1270.055770874): select jos_google_plus.link from jos_google_plus where cat=10

162 (41.007995605469): select jos_linkedin.link from jos_linkedin where cat=10

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