Open Access

Combination of radiotherapy and ICIs in advanced hepatocellular carcinoma: A systematic review of current evidence and future prospects (Review)

  • Authors:
    • Cheng Ma
    • Xinlin Yu
    • Xialin Zhang
    • Lihong Su
    • Ou Jiang
    • Ran Cui
  • View Affiliations

  • Published online on: May 14, 2025     https://doi.org/10.3892/ol.2025.15088
  • Article Number: 342
  • Copyright: © Ma et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

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.
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July-2025
Volume 30 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Copy and paste a formatted citation
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Spandidos Publications style
Ma C, Yu X, Zhang X, Su L, Jiang O and Cui R: Combination of radiotherapy and ICIs in advanced hepatocellular carcinoma: A systematic review of current evidence and future prospects (Review). Oncol Lett 30: 342, 2025.
APA
Ma, C., Yu, X., Zhang, X., Su, L., Jiang, O., & Cui, R. (2025). Combination of radiotherapy and ICIs in advanced hepatocellular carcinoma: A systematic review of current evidence and future prospects (Review). Oncology Letters, 30, 342. https://doi.org/10.3892/ol.2025.15088
MLA
Ma, C., Yu, X., Zhang, X., Su, L., Jiang, O., Cui, R."Combination of radiotherapy and ICIs in advanced hepatocellular carcinoma: A systematic review of current evidence and future prospects (Review)". Oncology Letters 30.1 (2025): 342.
Chicago
Ma, C., Yu, X., Zhang, X., Su, L., Jiang, O., Cui, R."Combination of radiotherapy and ICIs in advanced hepatocellular carcinoma: A systematic review of current evidence and future prospects (Review)". Oncology Letters 30, no. 1 (2025): 342. https://doi.org/10.3892/ol.2025.15088