Adjuvant Chemotherapy for High Malignant Prostate Cancer

Inclusion Criteria: 1. Histologically confirmed prostate cancer diagnosed by biopsy or surgery with a Gleason score of 9-10 (GG grade 5) or containing Gleason 5 components. 2. No evidence of distant metastasis confirmed by imaging. 3. Expected to receive standard radical treatment or postoperative radiotherapy. 4. Estimated survival time greater than 12 months. 5. Aged ≥ 18 years. 6. Karnofsky Performance Status (KPS) ≥ 80. 7. Adequate blood count: white blood cell ≥ 3.5 × 10\^9/L, neutrophils ≥ 1.5 × 10\^9/L, platelets ≥ 100.0 × 10\^ Exclusion Criteria: 1. History of malignant tumors (except those cured for more than 5 years). 2. Previous abdominal radiation therapy. 3. Weight loss \> 10% within the past 6 months. 4. Pre-existing or concomitant bleeding disorders. 5. Active infections. 6. Significant cardiovascular disease (e.g., controlled hypertension, unstable angina, NYHA class ≥ II congestive heart failure, unstable symptomatic arrhythmias, or ≥ II peripheral vascular disease) or any condition deemed intolerable to chemotherapy by the oncology department.