Lenvatinib, Sintilimab Plus SIRT for Unresectable HCC

Inclusion Criteria: Unresectable HCC (BCLC stage B/C) with diagnosis confirmed by histology/cytology or clinically At least one measurable untreated lesion Intrahepatic tumors can be treated with 1-2 session of SIRT Child-Pugh score 5-7 Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 Life expectancy of at least 3 months Patients with active hepatitis B are allowed, but they need to receive antiviral treatment to achieve a HBV DNA<10^3 IU/mL Patients with hepatitis C need to finish the anti-HCV treatment Exclusion Criteria: tumor extent ≥70% liver occupation Tumor thrombus involving main portal vein or both the first left and right branch of portal vein Vena cava invasion Central nervous system metastasis Metastatic disease that involves major airways or blood vessels Patients who previously received hepatic arterial infusion chemotherapy (HAIC), transarterial chemoembolization (TACE), transarterial embolization (TAE), radiotherapy, systemic therapy, or immunotherapy for HCC History of organ and cell transplantation Prior esophageal and/or gastric varices bleeding History of hepatic encephalopathy Peripheral blood white blood cell count<3×10^9/L, platelet count<50×10^9/L Prolongation of prothrombin time ≥ 4 seconds Severe organ dysfunction (heart, lungs, kidneys) History of malignancy other than HCC HBsAg and anti-HCV antibody positive concurrently Human immunodeficiency virus (HIV) infected