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

Who May Qualify: - diagnosed by tissue sample (biopsy-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 - platelet count at least 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 willing to sign a consent form document - Able to undergo all mandated staging and follow-up investigations - Negative pregnancy test (for women of childbearing potential) Who Should NOT Join This Trial: - Expected prognosis \<6 months - Uncontrolled intracranial metastases - Previous radiotherapy, such that the delivery of further radiotherapy is not feasible - Unable to have necessary radiotherapy planning, radiotherapy related investigations/fiducials (if required) - 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 - Pregnant or lactating - Requiring ongoing treatment with a concomitant medication, which is contraindicated alongside radiotherapy (e.g. methotrexate) Always talk to your doctor about whether this trial is right for you.