Case Report and Literature Review of Multi-drugs Synergy and Targeted Comprehensive Treatment in Advanced Hepatocellular Carcinoma

Background: A 43-year-old female patient was found to have an abnormal liver function, abnormally elevated alpha-fetoprotein and space-occupying lesions in the liver on routine screening. The patient came to our hospital for further diagnosis and treatment. Case presentation: Investigations: Laboratory investigations, digital subtraction angiography (DSA) of the hepatic artery, abdominal ultrasound examination, and magnetic resonance imaging (MRI) scan were conducted using pathological staining and immunohistochemistry. Diagnosis: Clinical diagnosis: cT3NxM0. Barcelona clinic liver cancer (BCLC) staging: BCLC stage C. China liver cancer (CNLC) staging: CNLC IIIa. Discussion: The patient was hospitalized for the first time for transcatheter arterial chemoembolization (TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (HAIC). Then, the second and third hospital admissions were given HAIC based on FOLFOX. Camrelizumab and oncolytic virus were also injected into the liver cancer through the microcatheter in the first three treatments. On the fourth admission, the patient’s indicators were improved, and the tumor shrank. Furthermore, as the patient suffered adverse reactions the first few times, we suspended the treatment of FOLFOX and the oncolytic virus. Before surgical treatment, lenvatinib was used throughout the treatment. On the fifth admission, the patient underwent liver cancer resection. Conclusion: It proves the value of multiple combination therapy, which can provide guidance for patients with advanced hepatocellular carcinoma that cannot be surgically removed.