Objective To observe the efficacy and the toxicity of external irradiation combined with 252Cf brachytherapy on advanced cardiac carcinoma.Methods 48 patients with advanced cardiac carcinoma hospitalized during March 2007 to December 2010 were recruited,in which 39 cases were adenocarcinoma,5 patients were squamous carcinoma and 4 cases were signet-ring cell carcinoma.All cases had a Kamofsky above 80,no metastasis and received radiotherapy sequenced external and internal irradiation.The external irradiation was conducted under a 6MV X linear accelerator,and a dose of 38-45 Gy (2 Gy/22 f).The type ZH-1000 252Cf neutron breach-loading machine was used for brachytherapy with a dose of 12-16 Gy.Results Dysphagia cleared in all cases.The short-term efficacy (PR+CR) rate was 91.7 ％ (44/48).One and two year survival rate were,respectively,39.6 ％ and 6.3 ％.25 (52.1％) patients had gastrointestinal symptoms such as nausea,vomiting and impedance,and grade 1,2 neutropenia were occurred in 21 (43.8 ％) and 3 (6.3 ％) patients.Conclusion External irradiation combined with 252Cf brachytherapy is a safe,effective and tolerable treatment for advanced cardiac carcinoma.