IMRT Plus PD-1 Blockade and Lenvatinib for HCC With PVTT (Vp3) Before Liver Transplantation

Inclusion Criteria: * Patients must have pathologically or cytologically or by radiological criteria proven hepatocellular carcinoma（exceeding Milan criteria）; known mixed histology (e.g. hepatocellular carcinoma plus cholangiocarcinoma) or fibrolamellar variant is not allowed. * The maximum diameter of a single tumor ≤9cm. Or the number of tumors ≤3 and the maximum diameter of the largest tumors ≤5cm, and the sum of the maximum diameters of all tumors ≤9cm. * Vp3 PVTT according to Japanese Vp classification. * Without lymph node metastasis or extrahepatic metastasis. * Baseline AFP≥20ng/ mL * Has an eligibility scan (CT of the chest, triphasic CT scan and MRI of the abdomen) \<1 week before the treatment. * Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 7 days prior to Cycle 1, Day 1. * Has a Child-Pugh A-B7 liver score (5 to 7 points) within 7 days prior to Cycle 1, Day 1. * Laboratory tests within 7 days prior to Cycle 1, Day 1: * Neutrophils ≥1.5×109/L * Hemoglobin ≥8.5g/dL * Platelets ≥100×109/L, * Creatinine ≤1.5× upper limit of normal (ULN) and endogenous creatinine clearance ≥50ml/min (standard Cockcroft Gaul formula) * Total bilirubin ≤3×ULN, ALT≤5×ULN, AST≤5×ULN, INR≤1.7 * Has controlled hepatitis B (HBV-DNA\<105IU/ml) * The estimate time length between enrollment and liver transplantation should be at least 3 months. * No prior systematic therapy such as immunotherapy, targeted therapy and chemotherapy for HCC. * No prior loca…