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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Cancer Urology</journal-id><journal-title-group><journal-title xml:lang="en">Cancer Urology</journal-title><trans-title-group xml:lang="ru"><trans-title>Онкоурология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1726-9776</issn><issn publication-format="electronic">1996-1812</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1982</article-id><article-id pub-id-type="doi">10.17650/1726-9776-2026-22-1-92-103</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Tetrafecta radiation therapy for prostate cancer</article-title><trans-title-group xml:lang="ru"><trans-title>Тетрафективная лучевая терапия рака предстательной железы</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1873-1293</contrib-id><name-alternatives><name xml:lang="en"><surname>Novikov</surname><given-names>Roman V.</given-names></name><name xml:lang="ru"><surname>Новиков</surname><given-names>Роман Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8314-3722</contrib-id><name-alternatives><name xml:lang="en"><surname>Ponomareva</surname><given-names>O. I.</given-names></name><name xml:lang="ru"><surname>Пономарева</surname><given-names>О. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-5645-8576</contrib-id><name-alternatives><name xml:lang="en"><surname>Kruglova</surname><given-names>E. S.</given-names></name><name xml:lang="ru"><surname>Круглова</surname><given-names>Е. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3676-6246</contrib-id><name-alternatives><name xml:lang="en"><surname>Katunin</surname><given-names>A. S.</given-names></name><name xml:lang="ru"><surname>Катунин</surname><given-names>А. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4996-2927</contrib-id><name-alternatives><name xml:lang="en"><surname>Protoshchak</surname><given-names>V. V.</given-names></name><name xml:lang="ru"><surname>Протощак</surname><given-names>В. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7185-1967</contrib-id><name-alternatives><name xml:lang="en"><surname>Novikov</surname><given-names>S. N.</given-names></name><name xml:lang="ru"><surname>Новиков</surname><given-names>С. Н.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>novikov-spb@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">S.M. Kirov Military Medical Academy, Ministry of Defense of Russia</institution></aff><aff><institution xml:lang="ru">ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">St. Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncology) named after N.P. Napalkov</institution></aff><aff><institution xml:lang="ru">ГБУЗ «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический) им. Н.П. Напалкова»</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Pokrovskaya City Hospital</institution></aff><aff><institution xml:lang="ru">СПб ГБУЗ «Городская Покровская больница»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2026-07-10" publication-format="electronic"><day>10</day><month>07</month><year>2026</year></pub-date><volume>22</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>92</fpage><lpage>103</lpage><history><date date-type="received" iso-8601-date="2025-10-20"><day>20</day><month>10</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2026-02-27"><day>27</day><month>02</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, ABV-Press</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, АБВ-пресс</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">ABV-Press</copyright-holder><copyright-holder xml:lang="ru">АБВ-пресс</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://oncourology.abvpress.ru/oncur/article/view/1982">https://oncourology.abvpress.ru/oncur/article/view/1982</self-uri><abstract xml:lang="en"><p>The presented work formulates the basic principles of a new concept of planning radiation therapy for prostate cancer which allows to achieve high functional and oncological treatment results. It is based on a temporary change in the mutual topography of the irradiated gland and adjacent normal tissues due to perineal implantation of a paraprostatic biodegradable spacer. Formation of an additional distance between the prostate and the rectum allows not only to significantly reduce the risks of post-radiation rectal toxicity but also ensures safe local escalation of the dose, as well as its optimal spatial distribution in relation to other critical organs. This approach was named tetrafecta radiation therapy.</p></abstract><trans-abstract xml:lang="ru"><p>В представленной работе сформулированы основные принципы новой концепции планирования лучевой терапии рака предстательной железы, позволяющей достигать высоких функционально-онкологических результатов. В ее основе лежит временное изменение взаимной топографии облучаемой железы и прилежащих нормальных тканей, обусловленное промежностной имплантацией парапростатического биодеградируемого спейсера. Формирование дополнительного расстояния между предстательной железой и прямой кишкой позволяет не только значительно снизить риски постлучевой прямокишечной токсичности, но и обеспечивает безопасную локальную эскалацию дозы, а также оптимальное пространственное распределение радиационной нагрузки по отношению к другим критическим органам. Данный подход получил название тетрафективной лучевой терапии.</p></trans-abstract><kwd-group xml:lang="en"><kwd>prostate cancer</kwd><kwd>radiotherapy</kwd><kwd>stereotactic radiation therapy</kwd><kwd>tetrafecta</kwd><kwd>urethra-sparing</kwd><kwd>erectile dysfunction</kwd><kwd>spacer</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>рак предстательной железы</kwd><kwd>лучевая терапия</kwd><kwd>стереотаксическая лучевая терапия</kwd><kwd>тертрафекта</kwd><kwd>тетрафективная</kwd><kwd>уретросбережение</kwd><kwd>эректильная дисфункция</kwd><kwd>спейсер</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">нет</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Bianco F.J. Jr., Scardino P.T., Eastham J.A. Radical prostatectomy: long-term cancer control and recovery of sexual and urinary function (“trifecta”). Urology 2005;66(5 Suppl):83–94. 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