How would you treat an isolated urothelial cancer local recurrence abutting the duodenum?

My first question would be "why not surgery?" This would be my preferred approach unless there is some contradiction to surgery that I am unaware of. If surgery is contraindicated, I would use a conventionally fractionated approach and try to get to a dose of 5,940 cGy, but this would be following a detailed informed consent discussion with the patient, well-documented in the chart, regarding the risk that this entails as opposed to the risk of using a suboptimal dose in this "young, fit" patien...