
    lack of recruitment
  
['liver neoplasms', 'hepatocellular cancer']
['doxorubicin']

        Inclusion Criteria:

          -  Hepatocellular carcinoma larger than 3 cm and non-resectable, with a diagnosis
             established either by:

               -  dynamic imaging (non-invasively), showing a typical contrast enhancement and
                  wash-out

               -  histopathology

          -  satellite lesions are allowed (at most three lesions) as long as the doses constraints
             are still achievable

          -  Hepatocellular carcinoma belonging to Barcelona Clinic Liver Cancer Stage System class
             B

          -  Tumor must be measurable on a multi-phase MRI according to mRECIST criteria

          -  Non-tumoral liver volume ≥ 800 cc

          -  Child-Pugh (CP) A to B7 cirrhosis

          -  HCC Patients can be included if they require treatment prior to liver transplantation

          -  ECOG performance status 0-1

          -  AST/ALT < 5 times ULN

          -  Initial platelets ≥ 50 000 x 10E9/l, neutrophils > 1500 x 10E9/l, Hb > 9 g/dl

          -  Serum creatinine < 1.5 X normal, or calculated Creatinine clearance rate ≥ 60 mL/min

          -  As tumor biopsy can be performed after inclusion, pure hepatocellular carcinoma but
             also mixed hepatocellular carcinoma will be allowed in this trial. Cholangiocarcinoma
             cannot be included.

          -  Written informed consent form to be signed,

          -  Patient willing and able to comply to the follow-up schedule

          -  Patients in fertile age should use a contraceptive method during treatment and 4
             months after.

        Exclusion Criteria:

          -  Eligibility for resection or ablative treatments

          -  Extra hepatic spread of the disease

          -  Previous treatment of the same lesion with TACE

          -  Previous treatment with selective internal radiotherapy or radiotherapy to the upper
             abdomen

          -  Uncontrolled Ascites

          -  Uncontrolled Encephalopathy

          -  Any clinical sign of acute viral or non-viral hepatitis (new serological testing are
             not required)

          -  Known current pregnancy

          -  Uncontrolled active co-morbidity
      