Partial Volume High-Dose Irradiation in Renal Cell Carcinoma for Intra-TUmoural Control ALongside Current Management

Prior treatment

• Previous radiotherapy, such that the delivery of further radiotherapy is not feasible
• Unable to have necessary radiotherapy planning, radiotherapy related investigations/fiducials (if required)
• Requiring ongoing treatment with a concomitant medication, which is contraindicated alongside radiotherapy (e.g. methotrexate)

Other illness

• Co-morbidities or any psychological, familial, sociological or geographical condition which may preclude ability to undergo/attend investigations, treatment or follow-up
• Other active primary cancer

Other

• Expected prognosis \<6 months
• Uncontrolled intracranial metastases
• Pregnant or lactating

• Histologically confirmed renal cell carcinoma (RCC) (histological confirmation of metastasis not required) or clinically consistent with RCC as per multidisciplinary team (MDT) diagnosis.
• Not suitable for surgical resection, metastasectomy or ablative therapy due to tumour or patient factors
• All extracranial sites which clinically require radiotherapy (as per clinician discretion)
• Age ≥18 years
• Karnofsky Performance Status (KPS) ≥50
• Adequate baseline organ function applicable to site-of irradiation
• Haemaglobin ≥90g/dl
• Platelets ≥50
• Bilirubin \<3x ULN
• INR \<1.4 or correctable with vitamin K
• AST or ALT \<5x normal range
• Creatinine \<200umol/L (or established on dialysis). Note patients on dialysis are unable to have dynamic contrast enhanced MRI.
• The use of concurrent systemic therapy is acceptable
• Ability of the research subject to understand and the willingness to sign a written informed consent document
• Able to undergo all mandated staging and follow-up investigations
• Negative pregnancy test (for women of childbearing potential)