A single-center retrospective study analyzed 207 patients with colorectal liver metastases treated with transarterial chemoembolization with irinotecan-releasing beads who were unfit for resection or ablation. The inflammation-tumor burden interaction score (CT-IBS) combines dynamic inflammatory change as measured by the difference in C-reactive protein to albumin ratio (ΔCAR) between baseline and early post-treatment assessments with the number of metastases (< 5 vs. ≥ 5). Early radiological response (complete or partial) was observed in 75.7% of patients. Higher ΔCAR and greater number of liver metastases were independently associated with worse overall survival. CT-IBS divided patients into three prognostic groups with median overall survival of 27.3, 17.8 and 8.6 months (p < 0.001; area under the curve 0.703). The score thus stratifies progression-free survival and overall survival after the procedure.