Abstract
There is nothing to support Docetaxel as a first line treatment in metastatic prostate cancer. Hormonal treatment is still the gold standard. Chemotherapy should be initiated in symptomatic patients or if patients are at high risk of developing metastasis (PSADT < 3 months). Quality of life is the main endpoint of chemotherapy in metastatic prostate cancer, that should be monitored clinically. The dose of Docetaxel should be adapted according to the geriatric evaluation in elderly patients. Estramustine is still under evaluation. There is no gold standard for second line chemotherapy in castrate resistant prostate cancer. In this situation patients should be included in protocols.
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