The expression of prostate-specific membrane antigen (PSMA) on the surface  of prostate cancer  cells is increased with  tumor progression, which  is the  basis  for a theranostic approach in the  treatment of these patients. The PSMA ligand, labeled with the therapeutic radionuclide lutetium-177 (177Lu), delivers 177Lu beta particle radiation to PSMA-expressing prostate cancer  cells. Currently, PSMA-targeted radioligand therapy with  the  radiopharmaceutical  177Lu-PSMA-617 is  approved for  the  therapy of  patients with  metastatic castration-resistant prostate cancer  (mCRPC). We present a clinical  case  of successful use of this  method of treatment in our  center in a patient with  mCRPC,  progressing after  two  lines  of therapy — hormone therapy with  new generation of androgen signal  inhibitors (abiraterone, enzalutamide) and  chemotherapy with docetaxel.

In this study, we described a clinical case of unoperable squamous carcinoma in the thoracic esophagus, demonstrating the effectiveness of induction chemotherapy followed by independent chemoradiotherapy and brachytherapy in patients with metastatic esophageal carcinoma. The patient was treated with induction chemotherapy, concurrent chemoradiation with weekly carboplatin AUC 2 and paclitaxel 50 mg/m2 and brachytherapy. The most characteristic feature of this clinical case is that the use of brachytherapy in the complex treatment of patients with esophageal carcinoma allows increasing the dose in the target without increasing the risk of complications associated with the escalation of the radiation dose. Brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with external beam radiation therapy. In most patients, esophageal carcinoma is diagnosed at stages III–IV of the disease. Squamous cell esophageal carcinoma is an aggressive disease that, depending on the prevalence, requires various treatment methods, the search for the optimal one is still ongoing. The main standard of treatment in inoperable patients with squamous cell esophageal carcinoma is self — chemoradiotherapy. However, in patients with unoperable esophageal carcinoma, it is also possible to use induction chemotherapy followed by independent chemoradiotherapy and brachytherapy. The combined use of these methods of treatment in conditions of impossibility of surgical intervention is the method of choice in patients with stage III–IV of the disease. The standard dose of DLT for squamous carcinoma of the esophagus is 50.4 Gy. In the conducted studies, it was shown that the escalation of the dose to the tumor using remote radiation therapy leads to an increase in severe post-radiation injuries and an increase in the frequency of deaths. Induction chemotherapy plus concurrent chemoradiotherapy and brachytherapy to boost tumor, and improves disease control and survival.