AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child’s classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than the routinedose.For the patients with large and hypervascular tumor ofChild grade A liver function or ICG-R15 less than 20%,oilychemoembolization with 20-40mL Lipiodol is recommended. AIM: To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization (TACE) in the treatment of large hepatocellular carcinoma (HCC). METHODS: From January 1993 to June 1998,473 patients with unresectable hepatocellular carcinoma ware divided intotwo groups : 216 patients in group A received more than 20 mL iodized oil during the first TACE treatment; 257 patients in group B received 5-15 mL iodized oil in the same way.The Child’s classification and ICG-R15 for evaluating the liver function of the patient ware done before the treatment. During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil (Lipiodol) ware Epirubicin and Mitomycin.Ingroup A, 112 cases received 20-29mL Lipiodol in the firstprocedure, 85 cases 30-39 mL, 19 cases more than 40 mL.The largest dose was 53 mL and the average dose was28. 3 mL.In group B, 119 cases received 5-10 mL Lipiodol, 138 cases received 11-15 mL, and the average dose was 11.8 mL .RESULTS: High-dose Lipiodol chemoembolization caused tolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15 <20.But the patients with child grade B or ICG-R15> 20 had higher risk ofliver failure after high-dose TACE. Type II and type II lipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients (P <0.01). The resection rate and complete tumor necrosis rate in group A ware higher than those of group B (P <0.05). The 1-, 2-, 3-year survival rates of group Apatients with Child grade A ware 79.2%, 51.8% and 34.9%, respectively, better then those of group B (P <0.001) .CONCLUSION: High-dose Lipiodol can result in more complete tumor necrosis by blocking both arteries and small portal veins of the tumor. High-dose TACE for treatment of large and hypervascular hepatocallular carcinoma ispra ctically acceptable with the better effect than the routinedose. For the patients with large and hypervascular tumor ofChild grade A liver function or ICG-R15 less than 20%, oilychemoembolization with 20-40mL Lipiodol is recommended.