Ulyanovsk Medico-biological Journal

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DOI 10.34014/2227-1848-2026-2-6-25

RADIATION THERAPY AS A POTENTIAL APPROACH TO ENHANCING THE EFFICACY OF TARGETED RADIONUCLIDE THERAPY IN METASTATIC CASTRATION-RESISTANT PROSTATE CANCER

I.A. Baryshnikov, P.V. Sychev, E.V. Mayakova, Yu.A. Kaydash, E.L. Shaydiyarova, A.V. Belostotskiy

Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency, Dimitrovgrad, Russia

 

The combined use of external beam radiotherapy (EBRT) and targeted radionuclide therapy (tRNT) is considered a promising strategy to overcome resistance and enhance treatment efficacy in metastatic castration-resistant prostate cancer (mCRPC).

Objective. The aim of the study is to analyze and synthesize current preclinical and clinical data justifying the potential synergism of combining EBRT (including photon and proton therapy) with PSMA-targeted tRNT

Materials and methods. This review was performed in accordance with the key principles of the PRISMA guideline to ensure transparency and reproducibility of the literature search and selection process. Search for relevant publications was carried out in electronic databases PubMed/MEDLINE, Scopus and eLibrary.ru and covered the period from January 2000 to May 2024.

Results. Based on a comprehensive database search (PRISMA approach), the authors analyzed radiobiological mechanisms of interaction, including radiation-induced modulation of PSMA expression, the principle of spatial cooperation, and cumulative dosimetry issues. Furthermore, successful experiences with combination regimens in other malignancies (hepatocellular carcinoma, lymphomas, and neuroendocrine tumors) were reviewed in detail, serving as a conceptual framework for developing prostate cancer protocols.

Conclusion. Despite the limited number of direct clinical trials in prostate cancer, the accumulated preclinical and indirect clinical evidence strongly demonstrates the necessity and rationale for conducting controlled pilot Phase I/II trials to evaluate safety, determine optimal regimens and dosimetry models, and identify predictors of response to the combination therapy.

Key words: targeted radionuclide therapy, prostate cancer, metastatic castration-resistant prostate cancer, [177]Lu-PSMA-617, external beam radiation therapy, combination therapy, radiobiology, dosimetry.

 

Conflict of interest. The authors declare no conflict of interest.

Author contributions

Research concept and design: Belostotskiy A.V., Mayakova E.V.

Literature search, data processing: Sychev P.V., Kaydash Yu.A., Baryshnikov I.A.,

Shaydiyarova E.L.

Data analysis and interpretation, text writing and editing: Baryshnikov I.A.

 

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Received September 15, 2025; accepted January 22, 2026.

 

Information about the authors

Baryshnikov Ivan Anatol′evich, Candidate of Sciences (Medicine), Radiologist, Head of the Radionuclide Diagnostics Department, Nuclear Medicine Center, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Ulyanovsk region, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-8903-6012

Sychev Petr Vladimirovich, Radiologist, Head of the Nuclear Medicine Center, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Ulyanovsk region, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-3965-4661

Mayakova Elena Viktorovna, Deputy Director General for Medical Affairs, Chief Physician, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Ulyanovsk region, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-5551-818ХХ

Kaydash Yuliya Aleksandrovna, Radiologist, Head of the Radionuclide Therapy Department, Nuclear Medicine Center, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Ulyanovsk region, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-9957-1871

Shaydiyarova Ekaterina Leont′evna, Radiologist, Department of Radionuclide Therapy, Center for Nuclear Medicine, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Ulyanovsk region, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0009-0005-6325-378X

Belostotskiy Andrey Viktorovich, Doctor of Sciences (Medicine), Professor, Director General, Federal Scientific and Clinical Center for Medical Radiology and Oncology, Federal Medical and Biological Agency of Russia. 433510, Russia, Dimitrovgrad, Kurchatov St., 5v; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-3896-3182

 

For citation

Baryshnikov I.A., Sychev P.V., Mayakova E.V., Kaydash Yu.A., Shaydiyarova E.L. Belostotskiy A.V. Luchevaya terapiya kak vozmozhnyy metod povysheniya effektivnosti targetnoy radionuklidnoy terapii pri rake predstatelnoy zhelezy s mnozhestvennym metastaticheskim porazheniem [Radiation therapy as a potential approach to enhancing the efficacy of targeted radionuclide therapy in metastatic castration-resistant prostate cancer]. Ul′yanovskiy mediko-biologicheskiy zhurnal. 2026; 2: 6–25. DOI: 10.34014/2227-1848-2026-2-6-25 (in Russian).

 

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УДК 615.849.12+616.65-006

DOI 10.34014/2227-1848-2026-2-6-25

ЛУЧЕВАЯ ТЕРАПИЯ КАК ВОЗМОЖНЫЙ МЕТОД ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ ТАРГЕТНОЙ РАДИОНУКЛИДНОЙ ТЕРАПИИ ПРИ РАКЕ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ С МНОЖЕСТВЕННЫМ МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ

И.А. Барышников, П.В. Сычев, Е.В. Маякова, Ю.А. Кайдаш, Е.Л. Шайдиярова, А.В. Белостоцкий

ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства, г. Димитровград, Россия

 

Комбинированное применение дистанционной лучевой терапии (ДЛТ) и таргетной радионуклидной терапии (тРНТ) рассматривается как перспективная стратегия преодоления резистентности и повышения эффективности лечения метастатического кастрационно-резистентного рака предстательной железы (мКРРПЖ).

Цель. Анализ и синтез современных доклинических и клинических данных, обосновывающих потенциальный синергизм комбинации ДЛТ (включая фотонную и протонную терапию) и PSMA-направленной тРНТ.

Материалы и методы. Данный обзор выполнен в соответствии с ключевыми принципами руководства PRISMA для обеспечения прозрачности и воспроизводимости процесса поиска и отбора литературы. Поиск релевантных публикаций проводился в электронных базах данных PubMed/MEDLINE, Scopus и eLibrary.ru и охватывал период с января 2000 г. по май 2024 г.

Результаты. На основе проведенного поиска в базах данных (PRISMA-подход) проанализированы радиобиологические механизмы взаимодействия, включая модуляцию экспрессии PSMA под воздействием облучения, принцип пространственного сотрудничества и вопросы суммарной дозиметрии. Подробно рассмотрен положительный опыт применения комбинированных режимов при других нозологиях (гепатоцеллюлярная карцинома, лимфомы, нейроэндокринные опухоли), который служит концептуальной основой для разработки протоколов при РПЖ.

Выводы. Несмотря на ограниченность прямых клинических исследований при РПЖ накопленные доклинические и косвенные клинические данные убедительно свидетельствуют о необходимости и обоснованности проведения контролируемых пилотных исследований I/II фазы для оценки безопасности, определения оптимальных режимов и дозиметрических моделей, а также выявления предикторов ответа на комбинированную терапию.

Ключевые слова: таргетная радионуклидная терапия, рак предстательной железы, метастатический кастрационно-резистентный рак простаты, [177]Lu-PSMA-617, дистанционная лучевая терапия, комбинированное лечение, радиобиология, дозиметрия.

 

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Вклад авторов

Концепция и дизайн исследования: Белостоцкий А.В., Маякова Е.В.

Литературный поиск, обработка материала: Сычев П.В., Кайдаш Ю.А.,

Барышников И.А., Шайдиярова Е.Л.

Анализ и интерпретация данных, написание и редактирование текста: Барышников И.А.

 

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Поступила в редакцию 15.09.2025; принята 22.01.2026.

 

Авторский коллектив

Барышников Иван Анатольевич – кандидат медицинских наук, врач-рентгенолог, радиолог, заведующий отделением радионуклидной диагностики Центра ядерной медицины, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-8903-6012

Сычев Петр Владимирович – врач-радиолог, начальник Центра ядерной медицины, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-3965-4661

Маякова Елена Викторовна – заместитель генерального директора по медицинской части – главный врач, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-5551-818Х

Кайдаш Юлия Александровна – врач-радиолог, заведующий отделением радионуклидной терапии Центра ядерной медицины, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-9957-1871

Шайдиярова Екатерина Леонтьевна – врач-радиолог отделения радионуклидной терапии Центра ядерной медицины, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0009-0005-6325-378X

Белостоцкий Андрей Викторович – доктор медицинских наук, профессор, генеральный директор, ФГБУ «Федеральный научно-клинический центр медицинской радиологии и онкологии» Федерального медико-биологического агентства России. 433510, Россия, Ульяновская область, г. Димитровград, ул. Курчатова, 5в; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-3896-3182

 

Образец цитирования

Барышников И.А., Сычев П.В., Маякова Е.В., Кайдаш Ю.А., Шайдиярова Е.Л. Белостоцкий А.В. Лучевая терапия как возможный метод повышения эффективности таргетной радионуклидной терапии при раке предстательной железы с множественным метастатическим поражением. Ульяновский медико-биологический журнал. 2026; 2: 6–25. DOI: 10.34014/2227-1848-2026-2-6-25.