Optimized protocol for systemic treatment of advanced liver cancer

  Primary hepatocellular carcinoma with ascites: It can be treated with Chinese medicine or western medicine diuretics first. After ascites subsides, according to the situation of tumor in liver, it can still be treated according to the above method. If the ascites is hematogenous, it is not easy to subside; if there is cancer thrombus in portal vein or hepatic vein, diuretics of Chinese and Western medicines are not effective. If primary hepatocellular carcinoma nodules rupture and bleed, hemostatic treatment should be given, and abdominal compression bandage should be applied at the same time.  For primary hepatocellular carcinoma with jaundice: if it is obstructive jaundice caused by mass compression in the hilar area, local radiation therapy, local intratumoral injection, interventional therapy, internal stenting or external drainage can be used; if it is non-jaundice, Chinese medicine treatment and liver preservation therapy can be given.  Primary liver cancer with lung metastasis: If the primary liver cancer has been controlled and there is only a single lung metastasis, resection or local radiotherapy can be considered. For multiple metastases or diffuse metastases in both lungs, radiotherapy (whole lung irradiation), chemotherapy or biotherapy can be considered. If the primary foci of liver cancer are not treated or not controlled by treatment, and the metastases are single or more limited, radiotherapy can also be considered.  If the metastasis is diffuse in the whole lung, biological therapy, chemotherapy or Chinese medicine can be used.  For advanced primary liver cancer bone metastases: If the metastases are single or several, radiotherapy can be used. If bone metastases are extensive, chemotherapy, biotherapy or radionuclide treatment can be given, as well as treatment with bone phosphine and Akodan.  If there is cancer thrombus in portal vein, hepatic vein or inferior vena cava: Hepatic artery infusion chemotherapy can be tried, but hepatic artery embolization is generally not used.