Proton Beam Radiotherapy Followed by Tecentriq and Avastin for Primary Liver Cancer With Vp2-4 Portal Vein Invasion

Exclusion Criteria

• •13. no limitation according to the size and number of tumors in the liver.
• •Patients with HCC meeting all of following criteria;
• •1. previous history of systemic treatment for HCC (If systemic treatment for HCC has been performed at least once, it will not be enrolled in this study.) However, registration is permitted if the previous systemic treatment is for adjuvant purposes or treatment for other cancers. Also allowed if previous HCC treatment is local treatment. However, cases with a history of previous upper abdominal radiotherapy (including proton therapy and heavy particle therapy) are excluded.
• •2. any type of anticancer agent (including investigational) within 2 weeks before enrollment
• •3. Having active brain metastasis or leptomeningeal metastasis need surgery or steroid therapy
• •4. Moderate to severe or intractable ascites
• •5. A history or presence of hepatic encephalopathy
• •6. Presence of active bacterial infection
• •7. Untreated active chronic hepatitis B or active hepatitis C
• •8. History of portal hypertension with bleeding within the past 6 months
• •9. Prior liver transplant
• •10. Uncontrolled severe medical comorbidity
• •11. unhealed wound
• •12. uncontrolled electrolyte imbalance
• •13. Non-interruptible therapeutic use of anticoagulants or thrombolytics
• •14. History of uncontrolled or autoimmune disease, or immunocompromised
• •15. interstitial lung disease
• •16. Other malignant disease (a history of treated malignancy -other than HCC- is allowable if the patient's malignancy has been in complete remission, off chemotherapy and without additional surgical intervention, during the preceding two years)
• •17. Mentally retarded/medically incapable of consent