Background Castration-resistant prostate cancer (CRPC) has a dismal prognosis. Despite treatment, median survival of these patients is around 12-22 months. Case Presentation In this report, we present the case of a 71-year-old man, with CRPC and painful bone metastases treated with an association of middle-half-body radiotherapy, androgen deprivation therapy (ADT) and cyclophosphamide-based metronomic chemotherapy. Five years after palliative radiotherapy the patient is still receiving metronomic chemotherapy and ADT. He is totally asymptomatic, with undetectable PSA values and negative 18F-Choline-PET/CT. The only side-effect was the development of non-insulin-dependent diabetes. Conclusion This treatment for its tolerability and feasibility, it could be particularly useful in older patients with CRPC. Furthermore, considering the low costs, it could be an important therapeutic option for patients living in low-resourced countries.

Keywords: Metronomic chemotherapy, radiotherapy, prostate neoplasms, CRPC, case report