With the advent of the new century, minimally invasive treatment of tumors has been refreshed in terms of equipment, materials as well as technology and methods, and its reliance on the rapid development of high and new technology has shown a broad prospect and full power. It is a modern tumor treatment method based on medical imaging, guided by imaging technology, integrating advanced medical imaging technology, drug therapy, biology, gene technology and high technology (such as radiofrequency ablation, laser, ultrasound focusing, endoscopy, luminal microscopy, etc.), with the advantages of precise positioning, accurate treatment, small trauma, light pain, and exact curative effect. Minimally invasive tumor treatment in the 21st century has been developed from traditional tumor interventional radiology to MRI minimally invasive treatment, CT minimally invasive treatment, DSA minimally invasive treatment, endoscopic and luminal minimally invasive treatment, covering a variety of therapeutic methods such as drug therapy (e.g., thrombolysis, chemoembolism), ablation therapy, minimally invasive guide of biogene therapy, and so on. With the development of modern imaging technology and the change of people’s health concept, health care consciousness and the continuous improvement of the requirements for the quality of life, minimally invasive therapy has become the most active and an emerging specialty in the field of oncology treatment with a broad development prospect. At present, minimally invasive therapy for tumors is broadly divided into two categories: vascular minimally invasive therapy and non-vascular minimally invasive therapy. The former includes endovascular drug perfusion, endovascular embolization, vasodilatation and angioplasty, endovascular stent implantation, and vena cava filter placement. The latter includes ablation therapy (physical ablation, such as radiofrequency, cryotherapy, laser, microwave, high-intensity focused ultrasound, etc.; chemical ablation, with anhydrous ethanol, acetic acid, cytotoxic chemotherapeutic drugs, etc.), radioactive particle tissue implantation therapy, lumpectomy (including thoracoscopic and laparoscopic techniques), endoscopic therapy, luminal dilatation plasty and internal stenting implantation. Looking at the current situation and characteristics of minimally invasive treatment of tumors, minimally invasive treatment of tumors in the 21st century is at the forefront of today’s medical development and has made remarkable progress, which is summarized as the following five aspects. With the continuous maturation and in-depth development of minimally invasive treatment of tumors, the scope of minimally invasive treatment of tumors and its connotation have been further expanded and perfected. With the continuous maturity and in-depth development of minimally invasive tumor therapy, the scope and connotation of minimally invasive tumor therapy have been further expanded and improved. Various minimally invasive therapies with different mechanisms and characteristics have been used in a coherent manner to improve the therapeutic efficacy of tumor treatment. Sequential combination mode is a minimally invasive treatment mode based on the biological behavior of tumors and clinical, imaging and laboratory examinations (such as tumor-related markers), and based on the principle of maximizing the destruction of tumors and maximizing the protection of human physiological functions and immune functions, combining several minimally invasive treatments organically according to the scientific order, so as to achieve the purpose of complementing each other’s strengths and improving the therapeutic efficacy. The sequential combined mode of minimally invasive treatment for tumors is especially the organic combination of vascular minimally invasive treatment and non-vascular minimally invasive treatment, which destroys and inactivates the tumor tissues through different mechanisms, and is the dual treatment of overall (regional) treatment at the level of the organ where the tumor is located, and local intensive treatment at the level of the lesion. Taking primary liver cancer as an example, the sequential joint application of both hepatic artery embolization chemotherapy (TACE) and ablation therapy, i.e., on the basis of TACE, after the imaging judgment and analysis of residual active components of the tumor, ablation therapy for intrahepatic lesions can completely necroticize the tumor tissues in the lesion area (including residual foci, subfoci and tiny lesions), which can further improve the effect of treatment. The mechanism is as follows: (1) More and more evidences show that primary hepatocellular carcinoma is a kind of multiple lesions (multicenter origin or early spreading along the portal vein).TACE therapy has the advantage of holistic treatment at the organ level, and also plays an important role in anti-vascular therapy, which can effectively reduce the blood supply of the tumor area, and also reduces the loss of drugs or heat due to the flow of blood in the process of treatment, so that the effect of ablation therapy is obviously strengthened. The effect of the treatment is significantly enhanced. On this basis, ablation therapy can overcome the deficiency of low rate of complete necrosis of lesions (about 20%) after simple TACE treatment, and maximally kill the residual tumor cells in or around the area of iodine oil deposition, so that the rate of complete necrosis of hepatocellular carcinoma can be significantly increased. (2) While treating liver cancer foci and intrahepatic microscopic lesions, TACE can mark intrahepatic lesions (including sub foci and microscopic lesions) with iodized oil, thus overcoming the deficiency of ablation therapy that is more likely to miss the smaller intrahepatic lesions and microscopic metastatic lesions; meanwhile, it can provide a more accurate basis for the next step of ablation therapy. (3) Ablation therapy can significantly prolong the time interval between TACE treatments, reduce the liver function damage caused by repeated TACE treatments and its resulting heavy complications, and improve the quality of patients’ survival and long-term survival rate. (4) Ablation therapy also has better therapeutic effect on portal vein cancer thrombosis. In recent years, the emergence of timely monitoring equipment and technology as well as the improvement of precise judgment and analysis of tiny lesions have further improved the pertinence and therapeutic efficacy of tumor treatment. For example, MRI-guided ultrasound focusing (HIFU) treatment can monitor the necrosis of tumor tissues in real time and guide the treatment in real time from the aspect of tumor function; PET/CT-guided minimally invasive treatment has the double advantages of functional PET/CT-guided minimally invasive treatment has the double advantages of functional imaging and high spatial resolution, which is of high value for residual tumor foci and metastatic tumors, and the accuracy of treatment can reach 90%-100%, and whether the tumor can be treated radically or not can be better supported and evaluated in evidence-based medicine. Modern medical imaging is the “eye” of minimally invasive tumor treatment. Advanced diagnostic and localization technology makes minimally invasive treatment of tumors tend to be more and more accurate and precise. With the help of various imaging equipment and imaging technology, effective targeted treatment is carried out by the timely monitoring and precise guidance and positioning of imaging equipment and technology. One-step precise positioning and one-step accurate treatment reflect the brand-new characteristics of minimally invasive treatment of tumor in the 21st century, which is the important point that minimally invasive treatment of tumor is superior to traditional treatment modes. Minimally invasive therapy combined with biological immunotherapy has gradually become a new mode of tumor treatment in the 21st century, which adopts minimally invasive therapy to fully reduce or remove the tumor load, and even achieve clinical cure (disappearance of clinical symptoms, disappearance of lesion activity in imaging, and negativity in relevant laboratory tests), and then combines with biological immunotherapy to further eliminate residual tumor cells, consolidate and improve the efficacy of minimally invasive therapy, and enhance the effectiveness of minimally invasive therapy, as well as to enhance the effectiveness of minimally invasive therapy and the effectiveness of tumor treatment. improve the efficacy of minimally invasive treatment, prevent local recurrence of tumor and effectively control metastasis. If minimally invasive treatment eliminates lesions that can be observed by macroscopic imaging, bio-immunotherapy mainly eliminates sub-imaging tumor lesions that cannot be shown by imaging. After minimally invasive treatment kills or inactivates tumor tissues to the maximum extent through anti-tumor vascular therapy or local direct physical or chemical destruction, biological immunotherapy is carried out to mobilize the body’s immune system, provide the body’s immune ability, eliminate residual tumor cells, in order to achieve the purpose of preventing local recurrence and metastasis of tumors, and to further improve the effect of tumor treatment. At present, the main ways of biological immunotherapy include: 1. Cytokine therapy: such as IL-2, IFN-γ, IFN-α, TNF-α and GM-CSF, etc., which usually improves the conditions for the immune system to exert anti-tumor immune effects; 2. Anti-tumor antibody therapy: using the specificity of antibodies as a guiding system of biological missiles to treat tumors, the first monoclonal antibody for treating tumors (Merovia, B-cell monoclonal antibody); 3. Tumor vaccine therapy: applying DC vaccines loaded with tumor antigens in vitro to activate the immune system by optimizing antigen presentation, inducing the body to produce specific anti-tumor immunity, etc.; 4. Anti-tumor effector cell therapy (cellular relay immunotherapy): injecting a large number of anti-tumor-active cells that have been activated, which can produce specific anti-tumor immunity (DC+CIK) can also produce non-specific anti-tumor immunity (CIK). These include (1) antigen-activated killer cells (TAK), (2) cytotoxic T lymphocytes (CTL), activated killer monocytes (AKM), (4) lymphokine-activated killer cells (LAK), (5) natural killer cells (NK), and (6) cytokine-induced killer cells (CIK). Bioimmunotherapy is ideal for treating microscopic metastases and preventing recurrence. Minimally invasive treatment can further improve patients’ quality of life and therapeutic efficacy by combining with bio-immunotherapy on the basis of reducing or removing tumor load, so as to achieve the purpose of cure. Minimally invasive therapy for radical tumors With the continuous development of minimally invasive therapy for tumors, under the guidance of evidence-based medicine, more and more advanced minimally invasive therapies can achieve the goal of eradicating certain tumors through the sequential joint application of each other as well as the new mode of minimally invasive therapy combined with biological therapy, which can achieve the curative effect comparable to that of some radical treatments for tumors. Therefore, following the “radical surgical resection”, “radical chemotherapy” and “radical radiotherapy”, radical minimally invasive treatment has emerged, such as “TACE sequential combined with biotherapy” for primary liver cancer. For example, “TACE sequential combined ablation therapy + biogenetic therapy” for primary liver cancer, and “ultrasound focused (HIFU) therapy + regional arterial perfusion therapy + biogenetic therapy” for breast cancer. Radical minimally invasive treatment is based on modern medicine, combined with advanced medical imaging technology and rapidly developing minimally invasive treatment technology. Like other treatments for tumors, radical minimally invasive therapy requires certain indications, such as early-stage tumors. For intermediate and advanced tumors, the efficacy of radical minimally invasive therapy can be achieved in some cases, and palliative minimally invasive therapy is still the goal in some cases. It can be foreseen: in the next 5 to 1O years, radical minimally invasive therapy combined with biogene therapy will become one of the preferred or important treatments for tumors such as early-stage liver cancer and breast cancer. The deeper meaning of radical minimally invasive therapy refers to local inactivation therapy, regional therapy at the organ level, and multilevel therapy at the systemic level, such as the new model of minimally invasive therapy for hepatocellular carcinoma (TACE sequential combined with ablation therapy and biogene therapy) that we advocate above. With the gradual deepening of people’s understanding of the biological behavior of tumors, we can also foresee that the customary terms such as “radical surgical resection” and “radical radiotherapy”, which have caused patients and physicians to have illusions or misinformation, will gradually disappear or simply serve as a lesson learned from the conventional tumor treatment plans or textbooks. will disappear from conventional tumor treatment protocols or textbooks or simply serve as a historical summary of lessons learned. It will be replaced by the brand-new concept of “radical treatment”, which refers to the disappearance of cancer cells at the local, organ and systemic levels, rather than the curative effect that can be achieved by a certain single level of treatment. Humanized and rationalized treatment Frankly speaking, “radical surgical resection”, “radical chemotherapy” and “radical radiotherapy” are the research and exploration of biological behavior of tumor, Radical surgical resection”, “radical chemotherapy” and “radical radiotherapy” are incomplete and limited knowledge in the process of researching, exploring and understanding the biological behavior of tumors, and they are a kind of misguidance in the choice of treatment for patients, at the cost of great damage or even loss of physiological or immune function of the organism. Although it reflects a kind wish of physicians and their determination and confidence in treating tumors, it is, in a sense, contrary to the concepts of humanization and rationalization, and restricts the progress of tumor treatment to some extent. For example, in 1890, Halsted founded the radical mastectomy for breast cancer, and then “extended radical surgery” and “super-expanded radical surgery” were widely used, but the survival rate of patients was not improved. In the 1980s, Fisher summarized the lessons learned from his predecessors and put forward a bold and scientific hypothesis based on evidence-based medicine, that is, “breast cancer is a systemic disease from the beginning, and the treatment of any primary foci and regional lymph nodes does not affect the survival rate of the patients”, and the momentum of radical mastectomy has been gradually curbed since then. has since been gradually curbed. Before that, however, millions of breast cancer patients had already paid a huge psychological, physical and quality-of-life price for it. If Fisher’s assumption and practice changed the history of breast cancer treatment, radical minimally invasive treatment will further change the history of breast cancer treatment, causing the second revolution of breast cancer treatment and benefiting millions of breast cancer patients; at the same time, it truly embodies a kind of humanized and rationalized treatment. Minimally invasive medicine and biomedicine have become two major trends and hotspots of medical development in the 21st century, and they are an important part of comprehensive tumor treatment. Minimally invasive therapy can not only significantly improve the sensitivity of tumor tissues to radiotherapy and chemotherapy, but also help to reduce the tumor load before surgery, which can effectively solve the problem of postoperative residual or recurrence. Minimally invasive therapy is both a palliative and a radical treatment, a humanized and individualized treatment, which has been accepted by more and more tumor patients and physicians. Although the traditional three major therapeutic means, surgery, chemotherapy and radiotherapy, play a certain positive role in the treatment of certain tumors, they are, however, limited in many cases by the poor general condition of patients, the insensitivity of tumor tissues to chemotherapeutic drugs, or by the maximum dose of radiotherapy. With the continuous development of high and new technology and the continuous updating of social medical concepts, the treatment methods with high trauma and high damage to human immune function will gradually develop in the direction of minimally invasive treatment and biogene therapy. The new mode of minimally invasive treatment combined with biogenetic therapy will become an important part of tumor treatment in the new century.