Hepatocellular carcinoma (HCC) is a major disease threatening human health, ranking sixth in the incidence of malignant tumors worldwide, with 626,000 new cases each year, about half of which occur in China, and most patients are inoperable. Transarterial chemoembolization (TACE) is currently the main treatment for inoperable hepatocellular carcinoma, which can cause ischemic necrosis of the tumor, but embolization is difficult to complete, prone to recurrence and metastasis, and the long-term efficacy is not satisfactory, while the efficacy of chemotherapy for hepatocellular carcinoma has been limited by drug resistance and liver function damage. Therefore, exploring new ways of highly efficient, targeted and low-toxic liver cancer treatment has become the most active research direction in interventional medicine. Doxorubicin is a new drug carrier liposome with high drug loading capacity, high affinity to tissues, slow release and biodegradability, prepared by encapsulating doxorubicin hydrochloride into nanoscale long-circulating liposomes, which can be easily taken up by reticuloendothelial system and concentrated in liver and spleen for intravenous administration, thus improving the efficacy of chemotherapeutic drugs on liver tumors. The application of doxorubicin liposomal chemoembolization via hepatic artery for the treatment of intermediate to advanced hepatocellular carcinoma is based on two considerations. On the one hand, TACE is difficult to completely destroy tumor cells, and residual tumor cells are stimulated by hypoxia to secrete pro-angiogenic factors, which in turn promote angiogenesis and create conditions for recurrence and metastasis. On the other hand, it has completely different pharmacokinetic characteristics from doxorubicin, increasing the circulation time of the drug in the body, ensuring that the drug can be targeted to local enrichment of cancer foci, greatly enhancing the anti-tumor activity of the drug by controlling the particle size of the drug, while reducing the original toxic side effects of the drug such as heart, bone marrow and hair loss, which is a more ideal anthracycline chemotherapy drug at present, while TACE makes the chemotherapy drug act on TACE allows chemotherapy drugs to act locally on the tumor and embolize the blood supply artery of the tumor, which has the advantages of killing tumor cells and destroying tumor vessels. The clinical prognosis of symptomatic and untreated HCC is poor, with a median survival of only 1.6 months. Despite the many treatment options available for this disease, the overall outcome is still unsatisfactory. Surgical resection can be effective, but because of the insidious onset of the disease, less than 10% of patients are suitable for surgical treatment after the onset of symptoms. For more than half a century, although chemotherapeutic drug treatment has achieved better efficacy in many tumors, the efficacy of systemic chemotherapy for HCC is disappointing, with an overall response rate of less than 10%. Nerenstone et al. concluded that the average survival of 640 patients in 13 groups was 4 months, and neither 5-fluorouracil (5-FU) nor adriamycin (ADM)-based regimens brought satisfactory results. Despite increasing the systemic dose, it did not improve the prognosis and increased the adverse effects. The fact that the multidrug resistance gene p-glycoprotein is present in 60% of hepatocellular carcinoma cells may explain the limited efficacy of chemotherapeutic agents. In the 1960s, Nasbaum and Baum et al. reported the use of transcatheter arterial drug infusion for the treatment of gastrointestinal bleeding, which laid the foundation for transcatheter hepatic arterial drug infusion (TAI) therapy. The efficacy of TAI can be improved and the incidence of adverse effects can be reduced. There are reports that the 6-month and 1-year survival rates of “one-time” high-dose chemotherapy with high-dose chemotherapy drugs are 33% and 13%, respectively, which are significantly higher than those of systemic chemotherapy, but apparently TAI still cannot achieve satisfactory efficacy. In 1974, Doyon et al. in France first reported the treatment of one case of HCC with transcatheter hepatic arterial embolization (THAE or TAE) using gelatin sponge (GS). The application of TAE led to a significant improvement in the prognosis of HCC. 1981 Chung et al. reported a median survival of 1 LS month in 47 patients with the application of Gs and steel-ring TAE. In 1976, Yamada et al. were the first to report the use of mitomycin (MMC) 10 mg or ADM 20 mg infusion and GS embolization. In 1976, Yamada et al. were the first to report the application of mitomycin (MMC) 10 mg or ADM 20 mg infusion and GS bolus for the treatment of HCC, with a 1-year survival rate of 43%. By 1983, Yamada et al [11] reported the efficacy of 120 patients with a 3-year survival rate of 15% and a median survival of 11 months. Nakakuma [l2] first used iodine oil and a chemotherapeutic drug emulsifier injected through the hepatic artery, followed by embolization of the artery with Gs (transcatheter oilyeh emoembolization, TOCE). TOCE) for the treatment of HCC, which led to a breakthrough in the TACE treatment of HCC. Iodine oil can be used as a carrier for chemotherapeutic drugs to bring them to the tumor site for slow release, resulting in significantly improved efficacy. 1 and 3-year survival rates for TOCE range from 44%-68% and 12-30% [13]. superselective embolization (hepatic segment embolization, subsegmental embolization and subsubsegmental embolization) and “hydromorphone “(cement) embolization method, which further improved the efficacy of TACE. nsshimine reported l, 3, and 5-year survival rates of 89.2%, 58.9%, and 30.2% in 95 patients with hepatic segment TACE. Currently, TACE therapy is considered the treatment of choice for surgically unresectable or postoperative recurrent HCC. As the number of TACE increases, liver function impairment becomes more pronounced, as reflected by changes in Child score and grading. Some authors now believe that liver function impairment after TACE is the main cause of poor long-term outcome, and after multiple TACEs many patients suffer from severe liver function loss, increased cirrhosis or even progressive liver atrophy, and eventually die of liver failure. Although Trinchet et al. excluded patients with significant liver function abnormalities from their study, 3/5 patients developed liver failure after TAcE. Katsushima et al. reported a 2.1% chance of acute liver failure within 2 weeks after TACE (13/623). Pelletial et al. found that 33% of patients achieved complete remission (CR) or partial remission (PR) after TAeE, but survival in the TACE group was not significantly different from that in the symptomatic group. Therein lies the reason for this difference. Therefore, how to further reduce the damage to non-hepatocellular carcinoma liver parenchyma has become the key to further improve the survival rate. In general, narrowing the embolization range and reducing the damage to normal liver tissue are important methods to reduce liver function damage, and since the 1990s, with the continuous improvement of interventional devices and techniques, super-selective embolization (hepatic segment embolization, sub-segment embolization) has played a role in improving the efficacy of TACE and reducing liver function damage, but it still cannot avoid serious liver function damage or even liver failure in some patients. People now recognize the role of high-dose chemotherapy TACE in aggravating hepatocellular damage, aggravating cirrhosis, weakening the body’s immune function, and inhibiting hematopoietic function. Therefore, there is a tendency to reduce the amount of chemotherapy drugs in TACE, i.e., only one appropriate chemotherapy drug is selected during TACE, and the chemotherapy dose is significantly reduced compared with the traditional dose. However, there is little relevant literature and further research is worthwhile. Adriamycin is currently one of the more commonly used drugs during interventional chemotherapy for abdominal malignancies, including hepatocellular carcinoma, but the apparent toxicity to the myocardium becomes an obvious obstacle to its clinical application. Doxorubicin is a nano-scale long-circulating liposome prepared by encapsulating doxorubicin hydrochloride with the advantages of high drug loading capacity, strong affinity with tissues, slow release and biodegradability by using a new drug carrier liposome, which is easily taken up by the reticuloendothelial system for intravenous administration and concentrated in the liver and spleen, thus improving the efficacy of chemotherapeutic drugs on liver tumors. Several authoritative medical institutions have confirmed that doxorubicin hydrochloride liposomes adopt the most advanced international cryptic liposome technology, which greatly improves the pharmacokinetic properties of existing anticancer chemotherapeutic drugs, and is a very promising new chemotherapeutic drug that can be widely used in clinical practice for a variety of cancers such as breast cancer, ovarian cancer, lymphoma, multiple myeloma, leukemia, stomach cancer, liver cancer, soft tissue sarcoma, head and neck tumors, etc. cancers. Some studies have shown that the peak concentration of liposomal adriamycin in the heart during interventional chemotherapy is significantly lower than that of systemic administration and the time to peak of the drug is significantly delayed, thus further reducing the cardiotoxicity of liposomal adriamycin. This suggests that the cardiotoxicity of liposomal adriamycin is significantly reduced compared with that of adriamycin in clinical interventional chemotherapy, and thus the dose can be increased to achieve more efficacy. Liposomal adriamycin is more readily absorbed by tumor tissues than adriamycin, and can slowly release the adriamycin encapsulated in it in tumor tissues, thus facilitating the antitumor effect of adriamycin (KalraAV, 2006). The tumor area is rich in blood supply and blood flow, which has a siphoning effect. The main components of liposomes are lecithin and cholesterol, and their molecules are spaced and oriented to form a lipid-like bilayer with hydrophobic groups inward and hydrophilic groups outward, which are easily adsorbed to tumor cells. The tumor tissue lacks a foreign body removal system, and the liposomes are not easily excreted. (2) LADM is slow-release, thus maintaining the effective drug concentration in tumor foci for a longer period of time. (3) LADM increases the drug content in tumor cells: ADM mainly relies on the active transport of membrane into the cell, while tumor cells have difficulty in entering the cell due to impaired membrane energy metabolism. It has been shown that liposomes enter the cell mainly through membrane melting and endocytosis. In most cases, no energy consumption is required, thus increasing the drug uptake by tumor cells. Maria Gonzfilez Cao achieved encouraging results in a case of hepatic metastasis from intestinal carcinoid tumor treated with liposomal adriamycin via hepatic artery infusion, which was well tolerated by the patient, while intraoperatively and postoperatively, hepatic artery administration was safe with minimal side effects. The successful application of doxorubicin hydrochloride liposomes will provide a high-quality and inexpensive therapeutic drug for the clinical treatment of liver cancer in China and the world, so that all tumor patients can enjoy the advantages of liposomal agents. The use of transhepatic arterial application of doxorubicin liposomal chemoembolization for the treatment of intermediate and advanced hepatocellular carcinoma is expected to significantly improve the quality of life and survival rate of patients, and its systematic study has important practical significance and broad application prospects, which will play a positive role in promoting the improvement of the treatment level of patients with large and medium-sized hepatocellular carcinoma in China and has good social and economic significance.