Abstract: Objective To observe the efficacy and safety of oxaliplatin（OXA） combined with LV／5-FU as FOLFOX 4 regimen for patients with primary liver carcinoma（PLC）. Methods From July 2004 to July 2012，77 patients were treated with FOLFOX 4 regimen as systemic chemotherapy. FOLFOX4 regimen， namely OXA 85 mg／m² iv，d1； LV 200 mg／m² iv 2h，d₁ and d₂； 5-FU 400 mg／m²，iv bolus，d₁ and d₂； 5-FU 600 mg／m²， CIV 22 h，d₁ and d₂， two weeks was a cycle. Tumor evaluation was performed every 3 cycles according to RECIST 1.0 criteria. The time to progression（TTP） and overall survival（OS） were observed. Serum AFP level was also monitored according to the schedule. Toxicities were evaluated according to NCI-CTC 3.0 and OXA special Levi neurotoxicity criteria. Results Seventy-seven patients were observed and 72 were evaluatable for efficacy. Three patients obtained partial response（PR），37 patients stable disease（SD） and 32 patients disease progression（PD）.The objective response rate（RR） was 4.2％ and disease control rate（DCR） was 55.6％.The median TTP and median OS were 2.7 months and 6.1 months， respectively. AFP response rate was 11.1％.The stratified analysis showed the efficacy of patients who received systemic therapy before was not inferior to that of initial treatment patients， but patients who have portal vein invasion or extrahepatic metastasis had worse efficacy and prognosis. The main observed adverse effects were leucopenia and mild periphery neurotoxicity. Conclusion Systemic chemotherapy with OXAbased FOLFOX 4 regimen for advanced PLC shows better disease control and survival benefit with mild adverse effects. Thus， it’s worthy of further clinical application widely.