Abstract: Objective To observe the efficacy and safety of gemcitabine combined with oxaliplatin（GEMOX） as the firstline regimen for advanced biliary tract carcinoma. Methods From July 2005 to April 2012，49 patients with biliary tract carcinoma were treated with GEMOX regimen as the firstline regimen. GEMOX regimen was taken as follow： gemcitabine 1000mg／m2 iv d1， d8； oxaliplatin 100mg／m2 iv d2. Twentyone days was a cycle. The efficacy was evaluated after 2 cycles. ResultsAll the patients received 239 cycles in total with the mean cylces was 488 ranged from 2 to 10， and the efficacy and side effects could be evaluated in all. In the 49 patients， 2（4.1％） got CR，8（16.3％） PR， 26（53.1％） SD and 13（26.5％） PD. The overall response rate（RR） was 20.4％ and disease control rate was 73.5％. The median time to pregress was 6.0 months and the median overall survival was 11.0 months. The main side effects were leukopenia， thrombocytopenia， vomiting／nausea and liver function impairment. They were mainly in grade 1-. Conclusion GEMOX regimen is effective and tolerable in the treatment of advanced biliary tract carcinoma， and is worth of further clinical application.