MANDARIN (S6371)

Inclusion Criteria:

• ≥18 and ≤80 age and provided study consent

• Patients diagnosed with HCC and clinically evaluated as inoperable (as per localpractice) or who refuse operation (ablation, hepatectomy and liver transplantation)

• At least one well defined HCC tumor measurable by mRECIST in contrast-enhanced MRI

• China liver cancer staging (CNLC) stage Ib~IIb

• Child-Pugh ≤ B7

• Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1

• Tumor burden ≤50% of the total liver volume

Exclusion Criteria:

• Presence of extra-hepatic metastases or additional malignancies aside from HCC

• Patients with hepatic artery malformation and unable to intubate hepatic artery

• Patients who are allergic to contrast agents or have renal insufficiency (Serumcreatinine>2mg/ml or Creatinine clearance<30mL/min) and are not suitable forinjection of contrast agents

• Severe pulmonary insufficiency (FEV1/FVC<50% or FEV1/predicting value<50% orMVV<50L/min)

• AST and ALT >5 times upper limit of normal

• Clinical manifestations of decompensated cirrhosis (Grade2/3 of ascites,gastrointestinal bleeding, hepatic encephalopathy, etc. according to EASL ClinicalPractice Guidelines)

• HCC invading biliary tract or causing biliary obstruction

• uncorrectable coagulation dysfunction and severe hemogram abnormality [Prothrombintime (PT)>6 seconds above control or PT-International normalized ratio (INR)>2.5,WBC<3.0x109/L, PLT<50x109/L]

• Infiltrative HCC tumor type

• Bilobar HCC disease

• Any presence of portal vein or hepatic veins or artery invasion

• Occlusion of portal vein completely with less collateral vessels

• Transjugular intrahepatic portosystemic shunt (TIPS) or Hepatic arterioportalfistula

• Patients during pregnancy or lactation

• Prior interventional therapy via hepatic artery or radiotherapy treatment for HCC

• Tc-99m macroaggregated albumin (MAA) hepatic arterial perfusion scintigraphy showsany deposition to the gastrointestinal tract that may not be corrected byangiographic techniques

• Radiation pneumonitis has been seen in patients receiving doses to the lungs greaterthan 30 Gy in a single treatment or greater than 50Gy in multiple treatment

• The absorbed dose of lung may exceed 30Gy in preoperative evaluation

• Receive any investigational therapy or anti-tumor therapy within 30 days prior tostudy enrollment

• Any other reason in which the investigator believes that the patient is unsuitableto participate in this trial