Abstract: Objective  To compare the FOLFOX4 regimen and RALOX regimen in the treatment of cardiotoxicity induced by advanced hepatocellular carcinoma（HCC）. Methods A total of 121 patients with advanced HCC were enrolled in 7 hospitals，including 63 patients with FOLFOX4 regimen （observation group） and 58 patients with RALOX regimen （control group）. The incidence of cardiotoxicity was compared between the two groups. Results The cardiotoxicity of the observation group and the control group were mainly grade Ⅰ and grade Ⅱ，but the incidence of grade Ⅰ and grade Ⅱ cardiotoxicity in the observation group were significantly higher than those of the control group（19.0% vs 6.9%，P=0.049；14.3% vs 3.4%，P=0.038），and the total incidence of cardiotoxicity in the observation group was also higher than the control group（36.5% vs 10.3%，P=0.001）. The incidence of abnormal electrocardiograph in the observation group was significantly higher than that in the control group（36.5% vs 10.3%，P=0.001）. However，there were no significant difference in left ventricular ejection fraction and myocardial enzyme elevation between the two groups（P＞0.05）. The incidence of arrhythmia and myocardial ischemia in the observation group were both higher than those of the control group（31.7% vs 10.3%，P=0.004；20.6% vs 6.9%，P=0.030）. Conclusions Grade Ⅰ and grade Ⅱ cardiotoxicity in the FOLFOX4 regimen caused by advanced HCC are higher than the RALOX regimen，and mainly characterized by arrhythmia and myocardial insufficiency

Key words: Hepatocellular carcinoma, FOLFOX4 regimen, Cardiotoxicity, 5-fluorouracil