AIM:To investigate the efficacy of transcatheter arterialchemoembolization (TACE) combined with radiotherapy forunresectable large hepatocellular carcinoma (HCC).METHODS:From June 1994 to June 1999,a total of 76patients with large unresectable HCC were treated with TACEfollowed by external-beam irradiation.89 patients with largeHCC,who underwent TACE alone during the same period,served as the control group.Clinical features,therapeuticmodalities,acute effects and survival rates were analyzedand compared between TACE plus irradiation group and TACEalone group.A multivariate analysis of nine clinical variablesand one treatment variable (irradiation) was performed bythe Cox proportional hazards model.RESULTS:The clinical features and therapeutic modalitiesexcept irradiation between the two groups were comparable(P>0.05).The objective response rate (RR) in TACE plusirradiation group was higher than that in TACE alone group(47.4 % vs 28.1%,P<0.05).The overall survival rates inTACE plus irradiation group (64.0 %,28.6 %,and 19.3 %at 1,3,5 years,respectively) were significantly higher thanthose in TACE alone group (39.9 %,9.5 %,and 7.2 %,respectively,P=0.0001).Cox proportional hazards modelanalysis showed that tumor extension and Child grade weresignificant and were independent negative predictors ofsurvival,while irradiation was an independent positivepredictor of survival.CONCLUSION: TACE combined with radiotherapy is more effective than TACE alone, and is a promising treatment for unresectable large HCC. AIM: To investigate the efficacy of transcatheter arterialchemoembolization (TACE) combined with radiotherapy for unsectable large hepatocellular carcinoma (HCC). METHODS: From June 1994 to June 1999, a total of 76 patients with large unresectable HCC were treated with TACE followed by external-beam irradiation. 89 patients with large HCC, who underwent TACE alone during the same period, served as the control group. Clinical features, therapeutic modalities, acute effects and survival rates were analyzed and compared between TACE plus irradiation group and TACEalone group. A multivariate analysis of nine clinical variables and one treatment variable (irradiation) was performed by the Cox proportional hazards model .RESULTS: The clinical features and therapeutic modalitiesexcept irradiation between the two groups were comparable (P> 0.05). The objective response rate (RR) in TACE plusirradiation group was higher than that in TACE alone group (47.4% vs 28.1%, P <0.05) .The overall survival rates in TACE plus irra diation group (64.0%, 28.6%, and 19.3% at 1,3,5 years, respectively) were significantly higher thanthose in TACE alone group (39.9%, 9.5%, and 7.2%, respectively, P = 0.0001) hazards modelanalysis showed that tumor extension and Child grade weresignificant and were independent negative predictors ofsurvival, while irradiation was an independent positivepredictor of survival.CONCLUSION: TACE combined with radiotherapy is more effective than TACE alone, and is a promising treatment for unresectable large HCC.