Definition of hormone resistance The following conditions must be met: 1. plasma testosterone reaches a depleted level (usually defined as a depleted level <50ng/ml); Shanhui, Department of Urology, West Hospital, Chaoyang Hospital, Beijing, Capital Medical University 2. plasma PSA rises progressively on three consecutive occasions measured at 2-week intervals; 3. anti-androgen drugs are discontinued for at least 4 weeks (at least 6 weeks for Comstock); 4. second-line endocrine therapy is applied. PSA continues to rise despite the use of second-line endocrine therapy; or there is continued progression of bone or soft tissue lesions. The main possible hypotheses are: 1) selective growth of hormone-resistant prostate cancer cell clones; 2) mutation of the androgen receptor; 3) adaptation of prostate cancer cells to the desmoplastic environment; 4) alteration of prostate cancer cell signaling pathways; 5) upregulation of anti-apoptotic genes, etc. The treatment of hormone-resistant prostate cancer is a multidisciplinary, multi-strategy comprehensive treatment. I. Maintenance androgen deprivation therapy If the patient's blood testosterone does not reach <50ng/ml, LHRH-a (luteinizing hormone-releasing hormone analogue) should be continued to ensure that blood testosterone is maintained at depleted levels. For a long time, prostate cancer has been considered a malignancy that is not sensitive to chemotherapy. 26 chemotherapy monotherapies were used to treat prostate cancer between 1988 and 1992, with an overall response rate of only 8.7% and a median survival time of 10-12 months, which was disappointing; moreover, chemotherapy brought numerous toxic side effects, which made chemotherapy once encounter a cold shoulder. The emergence of docetaxel has opened up a new prospect for chemotherapy in prostate cancer, and the two phase III clinical trials TAX327 and SWOG9916 reported in ASCO in 2004 have established the position of docetaxel-based chemotherapy as the first choice in HRPC treatment.