Ma Cheng, Yu Xinlin, Zhang Xialin, Su Lihong, Jiang Ou, Cui Ran
Department of Oncology, The First People's Hospital of Neijiang, Neijiang, Sichuan 641000, P.R. China.
Department of Oncology, The Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610000, P.R. China.
Oncol Lett. 2025 May 14;30(1):342. doi: 10.3892/ol.2025.15088. eCollection 2025 Jul.
Hepatocellular carcinoma (HCC) is a global health concern because of its rising prevalence and high fatality rates. Conventional treatments for advanced HCC (aHCC) have limited success, emphasizing the need for novel treatment options. Radiotherapy (RT) treatments, such as stereotactic body radiation and proton therapy, improve local tumor management via precision targeting. Moreover, immune checkpoint inhibitors (ICIs) that target the programmed cell death protein 1(PD-1)/PD ligand 1 (PD-L1) and cytotoxic T lymphocyte associated protein 4 (CTLA-4) pathways have promise for systemic antitumor effectiveness. The combination of RT and ICIs takes advantage of their complementary mechanisms: RT kills immunogenic cells and controls the tumor microenvironment to increase antigen presentation, whereas ICIs enhance and maintain antitumor immune responses. This combination enhances tumor regression and immune response in aHCC, improving response rate and progression-free survival with manageable safety. The present review aimed to summarize the rationale for combining RT + ICIs in patients with aHCC and clinical outcomes, as well as ways to enhance this combination technique. The combination of these models is a promising technique for improving outcomes for patients with aHCC and warrants further investigation.
肝细胞癌（HCC）因其患病率不断上升和高死亡率而成为全球关注的健康问题。晚期HCC（aHCC）的传统治疗效果有限，这凸显了对新型治疗方案的需求。放射治疗（RT），如立体定向体部放疗和质子治疗，通过精确靶向改善局部肿瘤控制。此外，靶向程序性细胞死亡蛋白1（PD-1）/PD配体1（PD-L1）和细胞毒性T淋巴细胞相关蛋白4（CTLA-4）通路的免疫检查点抑制剂（ICIs）有望实现全身抗肿瘤疗效。RT和ICIs的联合利用了它们的互补机制：RT杀死免疫原性细胞并控制肿瘤微环境以增加抗原呈递，而ICIs增强并维持抗肿瘤免疫反应。这种联合增强了aHCC中的肿瘤消退和免疫反应，提高了缓解率和无进展生存期，且安全性可控。本综述旨在总结aHCC患者中RT+ICIs联合治疗的理论依据和临床结果，以及增强这种联合技术的方法。这些模型的联合是一种有前景的技术，有望改善aHCC患者的治疗结果，值得进一步研究。
