Objective To compare the curative efficacy of conventional transcatheter arterial chemoembolization(C-TACE)and drug-eluting bead transcatheter arterial chemoembolization(D-TACE)combined with local thermal ablation in the treatment of massive hepatocellular carcinoma(HCC).Methods A total of 72 patients with massive HCC,who were admitted to the Nanyang Municipal First People's Hospital of China from April 2018 to June 2021,were enrolled in this study.By using random number table method,the patients were divided into study group(n=36)and control group(n=36).The patients of the control group were treated with local thermal ablation combined with C-TACE,while the patients of study group were treated with local thermal ablation combined with D-TACE.The clinical efficacy,tumor markers,liver function,serological indicators,blood perfusion indexes,and adverse reactions were compared between the two groups.All patients were followed up for two years.The progression-free survival(PFS)were compared between the two groups.Results The disease control rate(DCR)and objective response rate(ORR)in the study group were higher than those in the control group(P＜0.05).At 3 months after operation,the levels of alpha-fetoprotein(AFP)and prothrombin induced by Vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)were decreased in both groups(P＜0.05),which in the study group were obviously lower than those in the control group(P＜0.05);the alanine aminotransferase(ALT)level was increased in both groups,which in study group was lower than that in the control group(P＜0.05);the albumin(ALB)level was decreased in both groups(P＜0.05),which in the study group was higher than that in the control group(P＜0.05);the epidermal growth factor receptor(EGFR),vascular endothelial growth factor(VEGF)and thymokinase 1(TK1)levels were decreased in both groups(P＜0.05),which in the study group were lower than those in the control group;the blood volume(BV)and blood flow(BF)were decreased in both groups(P＜0.05),which in the study group was lower than those in the control group;the mean transit time(MTT)of contrast agent was increased in both groups(P＜0.05),which in the study group was higher than that in the control group.During the follow-up of two years,one patient in each group was lost in touch,the follow-up success rate was 97.22％.The median PFS in the study group and the control group was 15.41 months(95％CI:7.02-23.19)and 12.34 months(95％CI:6.16-22.30)respectively.The PFS curve of the study group was better than that of the control group(P＜0.05).Conclusion Local thermal ablation combined with D-TACE can improve liver function and blood perfusion in patients with massive HCC,with a remarkable clinical efficacy.This therapy can reduce tumor markers levels,regulate serum EGFR,VEGF and TK1 expressions,and prolong the median PFS,besides,it is clinically safe and reliable.