I. Radiotherapy Radiotherapy is one of the basic treatments for malignant tumors, but before the 1990s, radiotherapy was rarely given to patients with HCC because of its poor effect and large damage to the liver. radiation therapy (3DCRT), intensity modulated radiation therapy (IMRT) and stereotactic radiotherapy (SBRT) have become more and more mature and widely used since the mid-1990s, providing new opportunities for the treatment of HCC with radiotherapy. The increasing maturity and widespread use of IMRT and stereotactic radiotherapy (SBRT) have provided new opportunities for the treatment of liver cancer with radiotherapy. Domestic and foreign scholars have reported clinical practice and research on the use of modern precise radiotherapy techniques for the treatment of HCC that cannot be surgically resected, and for selected HCC patients, the 3-year survival rate after radiotherapy can reach 25%-30%. It is generally accepted that radiotherapy can be considered for patients with hepatocellular carcinoma whose tumors are confined and cannot be surgically resected due to poor liver function, or whose tumors are located in important anatomical structures that cannot be technically resected, or whose patients refuse surgery. In addition, for patients with distant metastases, palliative treatment is sometimes available to control pain or relieve compression, etc. (a) Indications for radiotherapy for hepatocellular carcinoma. (1) It is mainly applicable to: (1) good general condition, such as KPS≥70, liver function Child-Pugh grade A, single lesion; (2) those with residual lesions after surgery; (3) those who need local tumor treatment of liver, otherwise serious complications will arise, such as obstruction of liver portal, tumor embolism of portal vein and hepatic vein; (4) palliative treatment of distant metastases, such as lymph node metastasis, adrenal metastasis and bone metastasis. It can alleviate the patient’s symptoms and improve the quality of life. 2.As an important means of comprehensive treatment for hepatocellular carcinoma, the indications for radiotherapy are as follows: ① ① HCC confined to the liver: radiotherapy combined with hepatic artery intervention can significantly improve the efficiency and survival rate; ② HCC with cancer embolism: radiotherapy can target the cancer embolism that appears after surgical or interventional treatment as well as the cancer embolism in the primary foci (including inferior vena cava cancer embolism), which can prolong the survival of patients with grade C; ③ HCC with lymph node metastasis: radiotherapy HCC with lymph node metastasis: radiotherapy can significantly improve the survival of HCC patients with lymph node metastasis; ④HCC with adrenal metastasis: radiotherapy can relieve the symptoms of adrenal metastasis, but there is no evidence that radiotherapy can prolong survival; ⑤HCC with bone metastasis: radiotherapy aims to relieve symptoms and thus improve the quality of patient survival, but there is no evidence that it can prolong patient survival; ⑥ICC: radiotherapy can prolong the survival of patients with positive margins after resection and unresectable ICC patients. Most of the above radiotherapy for hepatocellular carcinoma is palliative in nature, with poor efficacy, and even if it can prolong survival, it is relatively short and cannot replace conventional treatment for hepatocellular carcinoma; however, other therapies for the above clinical conditions have failed to show better efficacy and stronger evidence-based medical evidence, so radiotherapy is still one of the important treatment options available, especially for extrahepatic metastases. (B) Techniques of radiotherapy for hepatocellular carcinoma. 1.Division of radiotherapy dose: The existing clinical experience shows that large division of radiation, such as 5Gy per time, 3 times per week, total dose of 50Gy, has strong tumor killing effect, but also has great radiation damage to the normal liver. Conventional segmentation irradiation, such as 2Gy/time, once a day, 5 times a week with a total dose of 50-62 Gy, is well tolerated by the normal liver and has significant tumor suppression. Which segmentation method is better needs further clinical practice and research comparison; however, for patients who need to relieve clinical symptoms in the short term, large segmentation radiotherapy is more suitable, because the tumor regression is faster and the symptoms improve significantly. 2.Radiotherapy plan. (1) Radiotherapy technique: The results of dosimetric comparison show that IMRT radiotherapy has better dose conformability in the target area and reduced irradiated dose to the normal liver compared with 3DCRT. Therefore, the 3DCRT technique is generally used first; if the dosimetric requirements are not met, then IMRT is used, which is more suitable for patients with large hepatocellular carcinoma that exposes the normal liver to larger doses, or patients with severe cirrhosis that cannot tolerate large doses of radiation. (2) Respiratory control: It is recommended to use respiratory control techniques such as active breath coordinator (ABC) to limit tumor motion during radiotherapy and thus reduce the radiation dose to the normal liver. (3) Target area localization: CT and MRI image fusion techniques combined with iodine oil deposition after TACE are recommended to determine the bulk tumor extent (GTV) of hepatocellular carcinoma. The clinical tumor volume (CTV) is GTV plus 5 mm-10 mm, and the planned volume (PTV) is CTV plus 6 mm when ABC device is used, and it should be determined according to the patient’s respiration when ABC is not used. Currently, some authors advocate two TACE sessions prior to radiation therapy, with an interval of 3-6 weeks before reassessing the need for further radiation therapy. This protocol may have the following benefits: (1) small hepatocellular carcinoma lesions can be detected and treated; (2) the identification of the tumor target area is facilitated; (3) the verification of the radiotherapy plan before its implementation is completed is facilitated; and (4) it is possible to delay the local dissemination in the liver and delay the appearance of dissemination in the liver. (iii) Complications of radiotherapy. Complications of radiotherapy include toxic side effects in the acute phase (during radiotherapy) and liver injury in the late phase of radiotherapy (within 4 months). (1) Toxic side effects in the acute period (during radiotherapy): ① anorexia, nausea, vomiting, and more serious upper gastrointestinal bleeding, especially in patients whose radiation field involves larger volume of duodenum, jejunum and stomach; ② acute liver function damage: manifested as rising bilirubin and rising serum ALT; ③ bone marrow suppression, especially in patients whose liver is illuminated in large volume, or patients with hypersplenism. 2, late damage of radiotherapy: mainly radiation induced liver disease (RILD), its clinical manifestations and diagnostic criteria: ① have received high dose radiotherapy to the liver; ② occur after the end of radiotherapy; ③ clinical manifestations are of 2 kinds: typical RILD: rapid onset, the patient rapidly develops a large amount of ascites and liver enlargement in a short period of time (ii) Atypical RILD: only impairment of liver function: AKP > 2 times the normal value, or ALT > 5 times the normal value, without liver enlargement and ascites; (iv) Clinical symptoms and impairment of liver function caused by the development of liver tumor can be excluded. RILD is a serious radiological complication which, when it occurs, can result in death from liver failure within a short period of time in more than 70% of patients; the main treatment is symptomatic, including the use of adrenal glucocorticoids and diuretics, along with aggressive hepatoprotective drugs and supportive therapy. The key to avoid the occurrence of RILD is to design the radiotherapy plan in such a way that the dose to the normal liver is limited to what can be tolerated. The radiation tolerated dose to the liver of patients with hepatocellular carcinoma in China is significantly lower than that reported abroad, because most hepatocellular carcinomas in China have an underlying cirrhosis. According to the domestic data. The tolerated dose (whole liver average dose) for the liver is 23 Gy for Chlild-Pugh class A patients and possibly 6 Gy for Chlild-Pugh class B patients. More care should be taken for patients prone to RILD, including pre-existing poor liver function, such as liver function of Child-Pugh class B; normal liver with large irradiated volume and high dose; patients with concomitant cancerous emboli in vessels, such as those in the portal and inferior vena cava. If TACE was used concurrently, the interval between TACE and liver radiotherapy was shorter than 1 month. In addition, patients who develop acute liver function damage during radiotherapy, such as ≥RTOG grade II liver injury, have up to 60% chance of developing RILD later if radiotherapy is continued. Therefore, radiotherapy should be discontinued in such patients to avoid the development of RILD after treatment. In conclusion, acute liver injury is often reversible and easily repaired; whereas late liver injury is often irreversible and is a serious radiation injury with a mortality rate of up to 80% once it occurs. The main causative factors include heavy underlying liver lesions (Child class B or C), excessive volume of irradiated normal liver tissue, and excessive dose. Prevention is the key, and the irradiation dose is limited to the tolerable range (generally considered to be 22 Gy for the national population). Systemic treatment (systemic treatment) HCC is difficult to treat because the same patient, the same organ, has two diseases of very different nature: malignancy and chronic liver disease, often affecting each other in a vicious circle. In China, HCC is common and highly prevalent, and most patients have a background of hepatitis B and cirrhosis, with an insidious onset and rapid progression. （Therefore, there is a great need to actively adopt a variety of comprehensive treatments, including systemic therapy.) In most cases, patients often have different degrees of liver function abnormalities at the time of hepatocellular carcinoma diagnosis. For patients with severe liver insufficiency (Child-Pugh class C), supportive symptomatic therapy alone is the most common and only option; those with normal or near-normal liver function (Child-Pugh class A or B) without indications for surgery, ablation or TACE therapy can be treated systemically. Available evidence suggests that systemic therapy is preferable to supportive symptomatic therapy for patients with advanced HCC without contraindications; it can reduce tumor load, improve tumor-related symptoms and quality of life, as well as prolong survival and have other benefits. It is generally accepted that systemic therapy is indicated for patients with advanced HCC who have developed extrahepatic metastases; localized lesions that are not amenable to surgical resection, radiofrequency or microwave ablation, or TACE therapy, or who have failed to progress with local therapy; diffuse hepatocellular carcinoma; and patients with combined portal vein trunk and/or inferior vena cava. (i) Molecular targeted drug therapy. The pathogenesis of hepatocellular carcinoma is known to be very complex, and its occurrence, development and metastasis are closely related to mutations of various genes, cell signaling pathways and abnormalities of neovascularization, among which there are several key links, which are the theoretical basis and important potential targets for molecular targeted therapy. Molecularly targeted drug therapy has unique advantages in controlling tumor proliferation, preventing and delaying recurrence and metastasis, and improving patients’ quality of life in HCC. In recent years, the application of molecularly targeted drugs for the treatment of HCC has become a new research hotspot and has received great attention and focus. Sorafenib is an oral multi-target, multi-kinase inhibitor that can block tumor angiogenesis by inhibiting vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR), and inhibit tumor cell proliferation by blocking Raf/MEK/ERK signaling pathway, thus exerting a dual inhibitory and multi-target blocking effect against HCC. Several international multicenter phase III clinical studies have demonstrated that sorafenib can delay the progression of HCC and significantly prolong the survival of advanced patients with a good safety profile; meanwhile, HCC patients with different geographical regions, different baseline levels and different prognostic factors have clinical benefits and similar efficacy with sorafenib treatment. The routine use of sorafenib is 400 mg, po. Bid; the application should pay attention to the impact on liver function, requiring patients with Child-Pugh A or relatively good B grade liver function; good liver function, early staging, and early dosing. The benefit is greater for those who use the drug early. The combination of sorafenib with hepatic artery intervention or systemic chemotherapy may provide more benefit to patients, as confirmed by several clinical observations and studies; the combination with other treatments (surgery, radiofrequency ablation, radiotherapy, etc.) is under investigation. Clinical trials of other new molecular targeted drugs, single drug or combined with surgery, interventional therapy and systemic chemotherapy for the treatment of hepatocellular carcinoma are also being carried out one after another. (2) Systemic chemotherapy (systemic chemotherapy) Systemic chemotherapy refers to chemotherapy administered mainly through oral, intramuscular or intravenous routes. Systemic chemotherapy has been used to treat liver cancer since the 1950s and is a common palliative treatment. Most conventional cytotoxic agents, including ADM/EADM, 5-Fu, PDD and MMC, have been tried in hepatocellular carcinoma, but all have low single-agent efficiency (generally <10%) and lack high-level evidence-based medical evidence of survival benefit; only isolated studies suggest that ADM-containing systemic chemotherapy may prolong the overall survival time of patients with advanced HCC compared with BSC; meanwhile, the poor reproducibility and significant toxic side effects have seriously affected its clinical application and efficacy. Therefore, for many years, relevant studies are less, low level and stagnant. 1.Arsenious acid injection. Arsenic trioxide (As2O3, arsenious acid) is the main component of traditional Chinese medicine arsenic, and scholars in China have made a major breakthrough in the treatment of promyelocytic leukemia by its injection (arsenious acid injection), which was firstly applied in China. Therefore, arsenious acid injection has been approved by the State Food and Drug Administration (SFDA) to increase the indications for advanced hepatocellular carcinoma, becoming the first systemic chemotherapeutic drug approved for the treatment of hepatocellular carcinoma through multicenter clinical studies. In clinical application, attention should be paid to the selection of appropriate patients and to the active prevention and control of adverse reactions, especially hepatorenal toxicity. 2. FOLFOX regimen. In recent years, a new generation of chemotherapeutic drugs such as oxaliplatin (OXA) has been introduced and applied one after another, which has made significant progress in chemotherapy for gastrointestinal cancer and significantly improved the prognosis, which has promoted and inspired the research of chemotherapy for liver cancer and challenged and questioned the traditional concept that liver cancer is not suitable for systemic chemotherapy. A series of clinical observations and phase II studies have been conducted at home and abroad, all of which suggest that OXA-containing regimens are effective in the treatment of hepatocellular carcinoma, with improved objective efficiency, ability to control disease progression, alleviate symptoms, and possibly prolong survival, and are therefore widely valued. 2010 results of the international multicenter phase III FOLFOX 4 regimen with single-agent ADM control for palliative chemotherapy in patients with advanced hepatocellular carcinoma not suitable for surgery or local treatment (EACH study) The results of an international multicenter phase III clinical study (EACH study) were published and demonstrated that OXA-containing combination chemotherapy can provide better objective efficacy, control and survival benefit for patients with advanced HCC with a good safety profile. This study has received high attention from international and domestic academic circles, changing the status quo of the long-term lack of standard regimens for systemic chemotherapy for advanced HCC and causing a major change in the concept of liver cancer treatment. It is now believed that HCC is a tumor with some sensitivity to new chemotherapy regimens containing OXA and others. For patients with advanced HCC without contraindications, systemic chemotherapy is clearly superior to general supportive therapy and is an alternative treatment method. (4) patients with hepatic vascular obstruction after repeated hepatic artery embolization chemotherapy (TACE) or relapse after interventional therapy. Of course, systemic chemotherapy should be strictly controlled for clinical indications, timely assessment of efficacy, and close monitoring and prevention of adverse effects. In principle, systemic chemotherapy should not be administered to patients with one of the following conditions: ECOG > 2, Child-Pugh > 7; ② leukocytes < 3.0×109/L or neutrophils < 1.5×109/L, platelets < 60×109/L, hemoglobin < 90g/L; ③ abnormal liver and kidney function, aminotransferase (AST or ALT) > 5 (3) Significant abnormalities in liver and kidney function, with aminotransferase (AST or ALT) > 5 times normal value and/or bilirubin significantly elevated > 2 times normal value, serum albumin < 28g/L, creatinine (Cr) ≥ upper limit of normal value, creatinine clearance rate (CCr) ≥ 50mi/min; (4) Infectious fever, bleeding tendency, medium to large amount of ascites and hepatic encephalopathy. 3, other drugs. As several international randomized clinical studies (RCT) have not demonstrated a survival benefit, the application of triamcinolone acetonide, anti-androgen drugs or octreotide is not recommended as systemic therapy against hepatocellular carcinoma. However, octreotide can be used to control hepatocellular carcinoma combined with gastrointestinal bleeding and to relieve intestinal obstruction except. (iii) Chinese medicine treatment. Chinese medicine can help reduce the toxicity of radiotherapy and chemotherapy, improve cancer-related symptoms and quality of life, and possibly prolong survival, and can be used as an important adjunct to liver cancer treatment. In addition to the traditional dialectical treatment and taking tonics, over the years, China's drug regulatory authorities have approved several modern Chinese medicine preparations, including anti-cancer pills, Kanglaite, Huachansu, Eleutherococcus and Dextran injection and their oral dosage forms for the treatment of hepatocellular carcinoma, which have been widely used and accumulated many practical experiences in clinical practice, with certain efficacy and respective characteristics, and the patient's compliance, safety and tolerance. However, these drugs have been marketed for many years, and the early experimental and clinical studies are relatively weak and lack of high-level evidence-based medical evidence to fully support them, so in-depth studies are needed. (iv) Other treatments. It is generally believed that biological therapy can improve the quality of life of patients with hepatocellular carcinoma, help improve the anti-tumor efficacy and reduce the postoperative recurrence rate. Appropriate application of thymidine α1 can enhance the immune function of the body with adjuvant antiviral and antitumor effects; while long-term application of α interferon and its long-acting agents as adjuvant therapy after resection for patients with viral hepatitis B-related HCC can effectively delay the recurrence and reduce the recurrence rate. In patients with HCC with a background of hepatitis B and/or viral hepatitis C, special attention should be paid to screening and monitoring of viral load (HBV DNA/HCV RNA) and hepatitis activity. It is known that the above mentioned antitumor drug therapies (including TAI/TACE, molecular targeted therapy and chemotherapy) have the potential to activate the hepatitis virus; and active viral replication and hepatitis activity often impair the liver function of patients and significantly affect the implementation and effectiveness of antitumor therapy, which should be taken seriously. If hepatitis virus is found to be actively replicating, antiviral therapy must be actively carried out in a timely manner, such as nucleoside analogues, alpha interferon and its long-acting preparations, and thymidine alpha 1. In addition, throughout the treatment of hepatocellular carcinoma, it is necessary to strengthen the supportive and symptomatic treatment, including analgesia, protection of liver function, biliary support, correction of anemia, improvement of nutritional status, control of blood sugar for patients with combined diabetes, correction of hypoproteinemia, control of abdominal fluid and prevention and control of complications such as gastrointestinal bleeding. These supportive and symptomatic treatment measures are very important and necessary to reduce pain, improve patients' quality of life, and ensure the smooth implementation and effect of anti-tumor treatment. Because of the special characteristics of HCC, which mostly occurs on the basis of chronic liver disease or cirrhosis, highly malignant and complex and difficult to treat, special emphasis is placed on multidisciplinary standardized and comprehensive treatment; and on this basis, individualized treatment is advocated for different patients or different stages of the same patient. Some domestic scholars have proposed that different treatment strategies can be adopted according to the physical condition of liver cancer patients and ECOG scoring system, divided into two categories of ECOG score 0-2 and 3-4. (i) For patients with ECOG score of 3-4, they are often unable to withstand intense anti-tumor treatment because their general health condition is too poor, and are mainly given supportive symptomatic treatment and Chinese medicine treatment. (b) For patients with ECOG score 0-2, they can be divided into two groups, Child-Pugh A/B and Child-Pugh C, based on the Child-Pugh scoring system: 1. Treatment for Child-Pugh C patients is basically the same as above. For those of them with liver failure due to end-stage liver disease, liver transplantation is recommended if they meet the criteria for liver cancer liver transplantation indications. Currently, the Milan criteria are the most widely used criteria for liver transplantation for hepatocellular carcinoma worldwide. However, the Milan criteria are too strict and deprive some patients with liver cancer who have the potential to achieve good outcomes through liver transplantation of surgical opportunities. The requirements for the absence of large vessel invasion, lymph node metastasis and extrahepatic metastasis are relatively consistent, but the requirements for tumor size and tumor number are different. After thorough discussion by the expert group, the UCSF criteria were recommended, namely, a single tumor diameter ≤ 6.5 cm, or a number of multiple tumors ≤ 3 and each tumor diameter ≤ 4.5 cm, and the total diameter of all tumors ≤ 8 cm. 2. For patients with Child-Pugh A or B, according to the UICC-TNM scoring system, patients with no extrahepatic metastases (including distant and lymph node metastases) ( N0M0) and patients with extrahepatic metastases (N1 or M1). Patients without extrahepatic metastases were further classified by vascular invasion into two groups: those with cancer thrombosis of major portal branches or inferior vena cava, and those without major vascular invasion. The major portal branches were defined as the main trunk of the portal vein and grade 1 and 2 branches, which were generally imaging-visible cancer emboli; microvascular cancer emboli were not used as a differentiator here because they could be used for preoperative treatment decision making and because they had a stronger prognostic impact on patients than microvascular cancer emboli. For patients with extrahepatic metastases, systemic therapy is recommended, including molecular targeted drug therapy (sorafenib), systemic chemotherapy (FOLFOX 4 regimen or arsenious acid injection), biological therapy and Chinese medicine, etc.; at the same time, palliative radiotherapy (pain control of bone metastases) can be used as appropriate. 3.For patients with cancer thrombus in the main branches of portal vein (main portal vein and grade 1/2 branches), if complete resection of the tumor and the naked eye cancer thrombus is not expected, radiotherapy and/or portal stent implantation and TACE are recommended; for patients whose tumor and cancer thrombus can be removed in whole, "surgical resection of liver cancer, portal vein embolization, chemotherapy pump implantation + postoperative portal vein heparin flushing, continuous infusion chemotherapy + TACE" is recommended. This can significantly improve the survival rate of patients with hepatocellular carcinoma combined with portal vein cancer embolism and reduce the recurrence rate of postoperative metastasis. For patients with inferior vena cava thrombosis, if it is caused by tumor compression and the patients are asymptomatic, they can be treated with TACE without stent placement and observe whether the tumor can shrink. If the cancer embolism is caused by tumor invasion of the inferior vena cava, it is recommended to place inferior vena cava stent or stent at the same time of TACE, and can be combined with radiation therapy. All these patients, if they can tolerate, are recommended to combine or sequential application of systemic therapy (such as Sorafenib, FOLFOX 4 protocol chemotherapy, application of arsenious acid injection and Chinese medicine, etc.). 4. For patients without vascular invasion, further stratification will be based on the number of tumors and the maximum diameter of tumors (all judged by preoperative imaging results). For patients with more than 4 tumor numbers, TACE is recommended to control the liver tumor, and surgical resection treatment is generally not advisable to be considered first. The above treatment can also be combined with ablation therapy. 5. For patients with 2-3 tumor numbers and maximum tumor diameter >3cm or single tumor >5cm, the survival rate of surgical resection is higher than that of TACE, but it should be noted that some patients cannot be surgically resected because of liver function reserve problem or incomplete envelope, and it is recommended that TACE can be used for these patients. it is necessary to judge whether to choose surgery from both hepatic resection technique and liver function reserve. It is generally accepted that patients with surgical resection should have a Child-Pugh classification score of ≤7. For patients who cannot tolerate or are not suitable for other anti-cancer treatment measures, liver transplantation can also be considered if they meet the UCSF criteria. So far, there is no evidence that TACE can reduce postoperative recurrence and prolong survival time, and TACE may bring complications, such as severe adhesions, gallbladder gangrene, bile duct necrosis and liver abscess, which will increase the difficulty of hepatectomy; therefore, for hepatocellular carcinoma that can be surgically resected, preoperative TACE is not recommended in principle. 6. For patients with single tumor diameter <5cm or tumor number 2-3, tumor For patients with a single tumor diameter <5cm or a number of 2-3 tumors with maximum diameter ≤3cm, surgical resection is firstly recommended for treatment. Based on the existing evidence-based medical evidence, ablation can also be considered for patients with tumors ≤3cm in maximum diameter. The advantages of surgical resection are low metastatic recurrence rate and high tumor-free survival rate, while percutaneous ablation has low complication rate, rapid recovery and short hospital stay. Radiation therapy can also be considered for patients who refuse surgery, or for patients with important organ diseases such as heart or lung disease or contraindications to anesthesia who are not suitable for surgery. For patients who cannot tolerate or are not suitable for other anti-cancer treatment measures, liver transplantation can be considered if they meet the UCSF criteria (Annex 2 and Annex 3). (iii) Treatment of underlying disease. When choosing treatment for HCC, emphasis should be placed on the treatment of the underlying liver disease (chronic hepatitis B, cirrhosis and liver dysfunction). When surgical resection or liver transplantation, local ablation, TAI/TACE, radiotherapy and systemic therapy (molecular targeted drug therapy and chemotherapy) are performed, it is advisable to pay attention to the examination and monitoring of viral load, and prophylactic application of antiviral drugs can be considered; at the same time, after hepatectomy In addition, standardized antiviral therapy is also advocated after hepatectomy. In conclusion, early detection, diagnosis and treatment of HCC must be given high priority; the principle of standardized and comprehensive treatment should be followed, which emphasizes the adoption of a multidisciplinary approach based on the underlying disease, tumor pathology type, site and extent of invasion (clinical stage), portal or inferior vena cava thrombosis and distant metastases, combined with the patient's general condition (PS ECOG score) and organ function status (especially the degree of liver function compensation). The multidisciplinary team (MDT) model is adopted to carry out extensive and in-depth multidisciplinary communication, discussion and cooperation, to formulate the best individualized treatment plan for patients, and to select or combine surgery, hepatic artery intervention, local ablation, radiotherapy, systemic therapy (molecular targeted therapy, chemotherapy, biological therapy, traditional Chinese medicine and antioxidant therapy) in a planned and rational manner. In order to avoid inappropriate or excessive treatment, we should select or combine various methods such as surgery, hepatic artery intervention, local ablation, radiotherapy, systemic therapy (molecular targeted therapy, chemotherapy, biotherapy, Chinese medicine and antiviral therapy, etc.) and symptomatic treatment to maximize tumor control, improve overall efficacy, improve patients' quality of life, and achieve the goal of prolonging survival or striving for eradication. Meanwhile, individualized treatment based on molecular typing of liver cancer may be an important direction for future development.