Transarterial Radioembolisation Combined with Targeted Therapy and Immune Checkpoint Inhibitors in Advanced Hepatocellular Carcinoma with Portal Vein Tumour Thrombus: Efficacy, Safety, and Dosimetric Analysis

Advanced hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) carries a dismal prognosis. This study evaluated the efficacy and safety of transarterial radioembolisation (TARE) combined with targeted therapy and immune checkpoint inhibitors (ICIs) in patients with HCC and Vp2–Vp4 PVTT, and explored the tumour absorbed dose (TAD) threshold associated with survival benefit. We retrospectively analysed 31 patients with HCC and Vp2–Vp4 PVTT treated with this triplet regimen. Tumour responses were assessed per mRECIST and RECIST 1.1. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The optimal TAD cutoff was identified through dose-threshold exploration and internally validated by bootstrap resampling. The objective response rate was 77.4