{
  "abstract": "Background\n\nThe optimal administration sequence of immune checkpoint inhibitors (ICIs) and radiotherapy (RT) for advanced hepatocellular carcinoma (HCC) remains unclear. This study compared the efficacy and safety of ICIs administered before vs after RT in advanced HCC patients.Methods\n\nThis single-center, retrospective cohort study employed propensity score matching (PSM). Patients with advanced HCC receiving sequential ICI-RT therapy (with or without concurrent targeted therapy) from January 2020 to December 2024 were divided into ICI+RT (ICI before RT, n=96) and RT+ICI (RT before ICI, n=100) groups, with treatment interval ≤14 days. Approximately half of patients in each group received concurrent targeted agents. Primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (TRAEs).Results\n\nAfter 1:1 PSM, 77 paired patients were analyzed (median follow-up 19.4 months). The RT+ICI group demonstrated longer median PFS (7.8 vs 5.6 months, HR 1.551, 95% CI 1.038-2.317, p=0.031), higher ORR (74.0% vs 54.5%, p=0.019), and lower progressive disease rate as best response (0.0% vs 10.4%, p=0.006). Median OS showed numerical but non-significant improvement (14.1 vs 12.5 months, HR 1.112, 95% CI 0.746-1.657, p=0.600). Grade 3-4 thrombocytopenia was more frequent in RT+ICI (42.9% vs 20.8%, p=0.006). Longitudinal neutrophil-to-lymphocyte ratio and lymphocyte-to-monocyte ratio changes suggested potential immune-priming effects of RT when administered before ICI.Conclusions\n\nIn this retrospective PSM cohort, RT followed by ICI was associated with improved PFS and tumor responses in advanced HCC, alongside manageable toxicity. These findings suggest potential value of RT as immune priming before ICI, though prospective validation is needed given the observational nature and single-center design of this study.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China.",
    "Department of Oncology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Luzhou, Sichuan, People's Republic of China.",
    "Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, People's Republic of China.",
    "Clinical Research Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China.",
    "Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Huaxi Fan"
    },
    {
      "affs": [
        0
      ],
      "name": "Rong Yu"
    },
    {
      "affs": [
        1
      ],
      "name": "Guishu Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiangyu Deng"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaolong Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Mingyue Rao"
    },
    {
      "affs": [
        2
      ],
      "name": "Kun He"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Jianwen Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/23yqrcdb3kv2g.bib",
  "cited_by": 0,
  "doi": "10.2147/jhc.s645600",
  "fulltext_url": "https://europepmc.org/articles/PMC13724073",
  "id": "23yqrcdb3kv2g",
  "issns": [
    "2253-5969"
  ],
  "landing_url": "https://europepmc.org/article/MED/42968863",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2721|Hepatocellular Carcinoma Treatment and Prognosis"
    ]
  ],
  "openalex": "W7224105845",
  "pdf_url": "https://europepmc.org/articles/PMC13724073?pdf=render",
  "pmcid": "PMC13724073",
  "pmid": "42968863",
  "published": "2026-10-28",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/23yqrcdb3kv2g.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42968863",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42968863"
    },
    {
      "first_seen": "2026-11-04T12:22:36Z",
      "native_id": "PMC13724073",
      "source": "pmc",
      "url": "https://doi.org/10.2147/jhc.s645600"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Hepatocellular Carcinoma Treatment and Prognosis",
      "subfield": "general"
    }
  ],
  "title": "Efficacy and Safety of Sequential Radiotherapy and Immune Checkpoint Inhibitors for Advanced Hepatocellular Carcinoma: A Single-Center PSM Retrospective Cohort Study.",
  "title_text": "Efficacy and Safety of Sequential Radiotherapy and Immune Checkpoint Inhibitors for Advanced Hepatocellular Carcinoma: A Single-Center PSM Retrospective Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:46Z",
  "url": "https://research.draconitic.com/paper/23yqrcdb3kv2g",
  "venue": "Journal of hepatocellular carcinoma",
  "versions": []
}