This study was designed to assess the effect of hepatic dysfunction from hepatic artery infusion (HAI) in advanced hepatocellular carcinoma (HCC). The patients were randomly assigned to receive epirubicin (n = 12, Epi group) or mitoxantrone (n = 14, Mito group) once every 4 weeks between 1992 and 1996. HCC patients were given 6-8 mg of mitoxantrone or 30-40 mg epirubicin. There was hepatic dysfunction in 27 patients after HAI, showing similarly elevated GOT, GPT, and total bilirubin. In the Epi group, the GOT value was slightly higher than in the Mito group, but it was not significant. After HAI chemotherapy, the GOT value showed a more than two-fold elevation. Six patients in the Epi group and 2 in the Mito group showed a significant difference. Our results indicated that mitoxantrone had less impact on hepatic function following HAI therapy.