Systemic Chemotherapy Versus Transcatheter Arterial Chemoembolization(TACE) for Hepatocellular Carcinoma

Inclusion Criteria:

• Eligible patients were age 18 to 75 years;

• The patients had histologically, cytologically,or clinically diagnosed unresectableHCC;and were ineligible for local invasive treatment. Clinically diagnosed patientshad to have: (1) evidence of HBV or HCV with hepatic cirrhosis; (2) a-fetoproteinlevels 400g/L; and (3) morphologic evidence of hypervascular liver tumor. Patients hadto have at least one measurable lesion according to RECIST (version 1.0; ≥2 cm oncomputed tomography [CT]; 1 cm on spiral CT or magnetic resonance imaging). Lesionsthat had undergone previous interventional or local therapy were not consideredmeasurable lesions.

• ECOG score≤2;

• life expectancy 3 months;

• Barcelona Clinic liver cancer (BCLC) stage B or C disease;

• Child-Pugh stage A or B disease;

• Adequate organ and marrow function, with neutrophil count≥1.5X10e9/L, plateletcount≥75×10e9/L, AST or ALT﹤2.5×upper limit of normal (ULN), total bilirubin

＜1.5×ULN, international normalized ratio ＜1.5;normal baseline left ventricularejection fraction_lower limit of normal for the institution. Patients with AST andALT＜5 ×ULN could be recruited if total bilirubin was in the normal range.

• Patients had to provide signed informed consent to participate.

Exclusion Criteria:

• documented allergy to lipoidal or other study drugs; any previous treatment beforerandom assignment;

• Previous liver transplantation;

• concomitant use of any other anticancer therapy, including interferon alfa and herbalmedicine approved by the local authority to be used as anticancer medicine (exceptpalliative radiotherapy to a nontarget lesion);

• CNS metastasis;

• Other serious illness or medical condition.