Abstract: Objective To observe the efficacy and safety of oxaliplatin plus capecitabine（XELOX regimen） for advanced patients with primary liver carcinoma（PLC）. Methods From April 2005 to December 2012， 31 advanced patients with PLC were enrolled. They were treated with XELOX regimen as systemic chemotherapy（OXA 150 mg， iv， d₁， d₁₅； CF 50mg， PO，d₁-d₁₄； CAP 1000mg each time， Bid， PO， d₁-d₁₄）. Four weeks was a cycle. Tumor evaluation was performed every 2 cycles according to RECIST 1.0 criteria. Toxicities were evaluated according to NCICTC AE 30. The time to progression（TTP） and survival rate of 6 months and 1 year were observed. Serum alpha fetoprotein（AFP） level was also monitored according to the schedule. Results Thirty-one patients were observed and 28 patients were evaluable for efficacy. One patient obtained complete response（CR）， 1 patient had partial response（PR）， 10 patients got stable disease（SD）， and 16 patients got disease progression（PD）. The objective response rate（RR） was 7.1％ and disease control rate（DCR） was 42.9％. The median TTP was 82 days. The survival rate of 6 months and 1 year was 68.2% and 57.7％， respectively. The serum AFP respond rate was 18.5％. The main adverse effects were myelosuppression and gastrointestinal reaction, most of these side effects were grade 1-2. There were no treatment-related death. Conclusion Systemic chemotherapy with XELOX regimen for advanced PLC shows better efficacy and some survival benefits with mild adverse effects. Thus， it's worthy of further study.