Combination of SFRT, PD-L1 Inhibitor, and Anti-VEGF in Advanced Hepatocellular Carcinoma

Inclusion Criteria:

1. Age: 18-75 years old;
2. Eastern Cooperative Oncology Group (ECOG) -Performance Status(PS):0-1 points；
3. Patient clinically or pathologically diagnosed with hepatocellular carcinoma；
4. Advanced hepatocellular carcinoma that is inoperable
5. Expected survival period≥3 months;
6. Liver function grade Child-Pugh A or better grade B (7 points);

Exclusion Criteria:

1. Prior invasive malignancy unless disease-free for a minimum of 2 years
2. Prior radiotherapy to the region of the liver that would result in overlap of radiation therapy fields
3. Prior selective internal radiotherapy/ablation, at any time
4. Untreated active hepatitis B or hepatitis C
5. Moderate to severe or intractable ascites
6. Untreated or incompletely treated esophageal or gastric varices
7. Severe, active co-morbidity, defined as follows:

   Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months prior to registration Myocardial infarction within the last 6 months prior to study entry Acute bacterial or fungal infection requiring intravenous antibiotics within 28 days prior to study entry A bleeding episode within 6 months prior to study entry due to any cause. Thrombolytic therapy within 28 days prior to study entry. Known bleeding or clotting disorder. Uncontrolled psychotic disorder
8. Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception
9. Prior solid organ transplantation.
10. Immunodeficiency diseases (including HIV) or autoimmune diseases require systemic immunosuppressive therapy (prednisone dosage\>10mg per day)
11. Prior or active thrombotic or bleeding disorders, hemoptysis, cerebral vascular accident, significant cardiac disease (ischemic or congestive heart failure), or gastrointestinal perforation.