ArticleFrontiers in oncology2025
SFRT combined with immunotherapy for a growing hepatocellular carcinoma after the failure of anti-angiogenesis and anti-PD1 treatment: a case report.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Bibliometric analysis of global research trends in spatially fractionated radiotherapy.Frontiers in oncology · 2026Pooled it
- Spatially fractionated radiotherapy and immunotherapy: a synergistic strategy for systemic anti-tumor immunity.Journal of translational medicine · 2026Review
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8 authors.
Funding
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Abstract
Background: Hepatocellular carcinoma (HCC) is one of the prevalent tumors worldwide, posing a global healthcare threat. The existing treatment options for large HCC have poor therapeutic effects and are prone to drug resistance. Spatially fractionated radiation therapy (SFRT) is a highly precise radiotherapy technique that delivers a concentrated high dose of radiation to a well-defined tumor target while minimizing radiation exposure to the surrounding normal tissues. SFRT specially delivers a non-uniform radiation dose to the target area instead of a homogeneous dose throughout the tumor volume. This steep dose gradient within the targeted tumor could increase the immune-rich infiltrate within the tumor, thus enhancing the efficacy of immunotherapy. Case report: A 22-year-old man was diagnosed with large HCC, classified as Barcelona Clinic Liver Cancer (BCLC) stage C. The patient received first-line systemic treatment with bevacizumab and atezolizumab, followed by locoregional therapy with hepatic arterial infusion chemotherapy (HAIC). The tumor rapidly grew over the next 2 months. Subsequently, the patient underwent SFRT combined with anti-PD1/CTLA4 (anti-programmed death 1/anti-cytotoxic T-lymphocyte antigen-4) immunotherapy and anti-angiogenesis treatment. SFRT was administered using volumetric modulated arc therapy, delivering 26.68 Gy in two fractions every other day to the high-dose spheres and 8 Gy in two fractions to the targeted tumor. The tumor regressed nearly 40% over 2 months after the treatment, without significant treatment-related side effects (grade 3 or 4 acute and subacute toxicities) observed during the subsequent follow-up exams. Conclusion: SFRT combined with immunotherapy is a promising strategy for large HCC.
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