Objective: To determine the efficiency and safety of transcathetral arterial chemoembolization (TACE) in unresectable (inoperable) colorectal cancers. Material and methods: The intervention is preceded by irrigography and CT examination, in native and post-contrast conditions, with the administration of water into rectum and consequent better imaging of the extent of the tumor, especially the growth into the surroundings. The catheter is introduced via arteria femoris into arteria mesenterica inferior and superselectively into the arteries, which supply the tumor. In the region of rectum it concerns arteriae rectales and in the area of sigmoideum it concerns the sigmoidal branches or the artery, which supplies the descending part of colon. In case of the right half of the colon the catheter is introduced into arteria mesenterica superior. The catheter is left in the artery for 5 days, when Adriablastin and 5-fluorouracil are administered, the latter often mixed with Hemafix to perform chemoembolization. In some cases the intervention is repeated twice to four times until the expected effect is reached. The control CT is performed 4 weeks after the end of the series for evaluation of response of the tumor to therapy and the result is evaluated according to Shibata: 1. complex response – disappearance of the tumor, 2. partial response – diminution of the tumor by more than 50%, 3. minimum response – diminution of the tumor by 25–50%, 4. no change – diminution of the tumor by less than 25%, 5. progression of the tumor – the tumor is enlarged by more than 25%. The time of survival was established by control in the relevant oncological registries, while 42 responses were obtained after 62 questionnaires sent out. Results: This method was used for the treatment of 42 patients in the period of 1990–2003, of them 26 men and 16 women. Twenty four patients out of 42 were operated on after chemoembolization and 11 of them are still alive, 13 patients died mostly of liver metastases, which were detected after the operation (8 patients). The shortest time of survival was three months, the longest being 13 years and the mean survival of the surgically treated patients was 72 months. The remaining 18 patients were not operated on, while all of them died. The shortest period of survival was one month, the longest being 23 months and the mean time of survival in non-operated on patient was 12 months. The time of survival in 11 patients, who were operated on and still survive is 98 months, the shortest being 3 years and the longest 13 years. From 42 patients with colorectal cancer, seven were treated for liver metastases with intra-arterial chemoembolization. The TACE series was performed twice to four times in 16 patients. The mean time of survival in the whole cohort of 42 patients was 45 months, the mean time of survival of the deceased patients being 25 months. The reasons for another series were following: 1) the surgeon refused to operate on the patient for a very extensive tumor, 2) the tumor did not diminish sufficiently after the first series, 3) the patient refused the operation. Points 1 and 3 represent indication for transcathetral arterial chemoembolization. The efficiency of therapy decreased from rectum to the ascending colon and coecum. Conclusion: Trans-catheteral arterial chemoembolism is a safe and relatively efficient method for the treatment of unresectable (inoperable) colorectal tumors. The efficiency decreased from rectum to the right colon.

        Key words: transcathetral arterial chemoembolism (TACE) – intraarterial chemoembolism – obliteration – cytostatics