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［目的］ 对比观察XELOX方案和FOLFOX4方案治疗中晚期肝细胞肝癌(HCC)的疗效和安全性。［方法］ 2013年2月至2017年4月，纳入53例中晚期HCC患者并随机分为两组，A组(n=27)XELOX方案治疗，卡培他滨1000mg/m2，口服，2次/d，d1～d14；奥沙利铂130mg/m2，静脉点滴，d1，21d为1个周期。B组(n=26)FOLFOX4方案治疗，奥沙利铂 85mg/m2，静脉点滴，d1；亚叶酸钙200mg/m2，静滴2h后予氟尿嘧啶400mg/m2静推，后续600mg/m2持续静滴2h，d1、d2，每2周为1个周期。比较两组患者的疗效及不良反应。［结果］ A组客观缓解率为14.8%，疾病控制率为59.2%，1年生存率为44.1%；B组客观缓解率为15.4%，疾病控制率为53.9%，1年生存率为37.7%；两组各项指标差异均无统计学意义（P＞0.05）。A组主要不良反应为骨髓抑制、消化道反应、肝功能损害、神经毒性和手足综合征，B组主要不良反应为骨髓抑制、消化道反应、肝功能损害和神经毒性，XELOX组不良反应评分较FOLFOX4组低（P＜0.05）。［结论］ XELOX方案治疗中晚期HCC疗效和标准方案FOLFOX4相当，总体不良反应较轻，患者生活质量较高，依从性较好，值得进一步研究。
[Objective] To observe the efficacy and safety of XELOX regimen and FOLFOX4 regimen in the treatment of advanced hepatocellular carcinoma (HCC). [Methods] From February 2013 to April 2017, 53 patients with advanced HCC were enrolled and randomly divided into two groups. Group A (n = 27) received XELOX regimen, capecitabine 1000 mg / m2 orally, twice / d, d1 ~ d14; oxaliplatin 130mg / m2, intravenous drip, d1, 21d for a cycle. B group (n = 26) FOLFOX4 regimen, oxaliplatin 85mg / m2, intravenous drip, d1; leucovorin 200mg / m2, iv infusion of fluorouracil 400mg / m2 static push, followed by 600mg / m2 continuous intravenous infusion 2h, d1, d2, every 2 weeks for a period. Efficacy and adverse reactions of two groups were compared. [Results] The objective response rate was 14.8%, the disease control rate was 59.2% and the one-year survival rate was 44.1% in group A; objective response rate in group B was 15.4%, disease control rate was 53.9%, and 1-year survival rate was 37.7% There was no significant difference between the two groups (P> 0.05). The main adverse reactions in group A were myelosuppression, digestive tract reaction, liver dysfunction, neurotoxicity and hand-foot syndrome. The main adverse reactions in group B were myelosuppression, gastrointestinal reaction, hepatic impairment and neurotoxicity. The scores of adverse reaction in XELOX group FOLFOX4 group was lower (P <0.05). [Conclusion] The efficacy of XELOX regimen in treatment of advanced HCC is comparable to that of standard protocol FOLFOX4. The overall adverse reactions are mild. The quality of life of patients with high XELOX regimen is better and the compliance is worthy of further study.