SBRT Plus Lenvatinib and TACE for Advanced Primary HCC: A Phase 3 Trial (SEARCH)

Inclusion Criteria: 1. Age 18-75 years old; 2. Patients with primary advanced HCC (in accordance with AASLD2018 guidelines for the diagnosis of HCC), without any previous treatment; 3. There is at least one measurable lesion in the liver according to mRECIST criteria, single tumor ≤ 10.0 cm or multiple tumors and tumor burden ≤50% , with portal vein tumor embolus; 4. ECOG score 0-1; 5. Child-Pugh class A; 6. Expected survival time ≥ 3 months; 7. Blood, liver and kidney function meet the following conditions: Neutrophil count ≥ 1.5 × 10 9 /L; Platelet count ≥ 60 × 10 9 /L; Hemoglobin ≥ 90 g/L; Serum albumin ≥ 30 g/L; Bilirubin ≤ 50 umol/L; AST, ALT ≤ 5 times the upper limit of normal, ALP ≤ 4 times the upper limit of normal; Prolongation of prothrombin time not to exceed the upper limit of normal by 6 seconds; Creatinine ≤ 1.5 times the upper limit of normal. Exclusion Criteria: 1. Extrahepatic metastases; 2. Previous history of liver or adjacent tissue radiation; 3. Previous history of hepatic encephalopathy, refractory ascites or gastric esophageal varices; 4. There are contraindications to TACE treatment, such as portosystemic shunt, liver flow ablation, significant atherosclerosis; 5. Hypersensitivity to intravenous contrast agents; 6. Pregnant or lactating women or subjects with family planning within two years; 7. With HIV, syphilis infection; 8. Accompanied by other malignant tumors or suffering from other malignancies within 5 years before enrollment; 9. Allogeneic organ transplant recipients; 10. Severe dysfunction of heart and kidney or other organs; 11. Active severe infection \> grade 2 (NCI-CTC version 5); 12. Suffering from mental and psychological diseases may affect informed consent; 13. Unable to take oral medication; 14. Participated in other drug clinical trials within 12 months before enrollment; 15. Active gastric or duodenal ulcers within 3 months before enrollment.