CapTemY90 for Grade 2/3 NET Liver Metastases

Inclusion Criteria:

* Patients with confirmed diagnosis of histologic grade 2 or 3 well differentiated neuroendocrine tumor with unresectable liver metastases (primary tumor or other extrahepatic disease may be present)
* Patients with at least one measurable liver metastases, with size \> 1cm (RECIST criteria)
* Patients with liver dominant disease defined as ≥50% tumor body burden confined to the liver
* Liver tumor burden does not exceed 50% of the liver volume
* Patent main portal vein
* At least 4 weeks since last administration of last chemotherapy and /or radiotherapy
* Age \>18 years.
* Life expectancy of greater than 6 months.
* ECOG performance status 0-2.
* Adequate liver function as measured by: Total bilirubin ≤ 2.0mg/dl, ALT, AST ≤5 times ULN, albumin ≥2.5g/dl.
* Patients must have adequate organ and marrow function as defined below:
* platelets \>100,000/mcL (may be corrected by transfusion)
* serum creatinine \< 2.0 mg/dl
* INR \<1.6, (may be corrected by transfusion)
* Ability to understand and the willingness to sign a written informed consent document.
* Women of child bearing potential and fertile men are required to use effective contraception (negative urine or serum βHCG for women of child-bearing age)

Exclusion Criteria:

* Contraindications to capecitibine or temozolomide
* Contraindicated for both contrast-enhanced MRI and CT
* Patients previously treated with transarterial embolization (with or without chemotherapy) or with radioembolization (Y-90 microspheres)
* Contraindication for radioembolization procedures:
* excessive hepatopulmonary shunt as determined by the investigator
* inability to deliver Y90 microspheres without risk of non-target embolization of extra-hepatic structures
* Subjects consenting to the trial who fail their simulation angiography will be removed from the study and replaced.
* Patients may not be receiving any other investigational agents.
* Absolute contraindication to intravenous iodinated contrast (Hx of significant previous contrast reaction, not mitigated by appropriate pre-medication).
* Choledochoenteric anastomosis, transpapillary stent or sphincterotomy of duodenal papilla;
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant and lactating women are ineligible