Brachytherapy Offers Alternative Treatment of Difficult Non Melanoma Skin Cancer

Radiation Oncologist Redical director of 21st Century Oncology of Arizona

Dr. Ajay Bhatnagar Interview with
Dr. Ajay Bhatnagar MD
Radiation Oncologist
Medical director of 21st Century Oncology of Arizona What is the background for this report? What are the main findings?

Dr. Bhatnagar: I recently presented updated data regarding my research at the American Society for Radiation Oncology (ASTRO) annual meeting in a poster titled “Electronic brachytherapy for the treatment of Non-Melanoma Skin Cancer: Results up to 5 years.”

For this clinical study, I have been using the Xoft® Axxent® Electronic Brachytherapy (eBx®) System® which is FDA cleared, CE marked and licensed in Canada for the treatment of cancer anywhere in the body, including early-stage breast cancer, gynecological cancers, and nonmelanoma skin cancer (NMSC) including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

For the treatment of nonmelanoma skin cancer, the Xoft System uses a proprietary, miniaturized x-ray source to deliver a precise dose of targeted radiation directly to the surface lesion. This treatment uses electronic brachytherapy (eBx) to target cancerous cells while sparing healthy tissue. It is painless, non-invasive and offers a number of patient benefits, including fewer treatments than traditional radiation therapy.

According to my findings, the Xoft System is safe and effective for the treatment of nonmelanoma skin cancer, with low rates of recurrence and excellent clinical outcomes. What should clinicians and patients take away from your report?

Dr. Bhatnagar: My hope is that with this data more clinicians will conclude that eBx can be a viable treatment option for patients who are not candidates for traditional nonmelanoma skin cancer treatments, such as Mohs surgery, surgical excision, curettage or cryosurgery.

Ideal candidates for treatment with the Xoft System include patients with lesions in surgically challenging locations (ear, nose, scalp, neck), or those with locations and/or medical conditions that contribute to difficulties in wound healing (lower extremities, diabetes, peripheral vascular disease), patients with medical comorbidities that may preclude them from surgery, patients on anticoagulants or with pacemakers, and patients who are not interested in pursuing surgery. The Xoft System offers patients a number of benefits, including:

  • Excellent (>90%) cosmesis with little to no side effects.
  • The ability to target cancer cells while sparing healthy tissue and organs.
  • Fewer treatments, as it typically requires only two visits a week for four weeks. Traditional radiation therapy can require daily treatments for up to six weeks.
  • Use of low voltage energy (50kV).
  • Minimal shielding requirements, enabling medical professionals to remain in the room during treatment.
  • Administration as an outpatient treatment, allowing patients to resume normal activities What recommendations do you have for future research as a result of this study?

Dr. Bhatnagar: I have been conducting clinical trials with the Xoft System since 2009. According to my studies, this treatment is a safe and effective treatment for NMSC, with low recurrence rates. I hope that these findings will inspire others to join in the research effort to provide further validation and new insights about this technology in the years ahead

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Ajay Bhatnagar, MD, MBA Biography

With a background in biomedical engineering, Dr. Ajay Bhatnagar has a broad range of experience in new technologies and research. He serves as the medical director of 21st Century Oncology of Arizona and has written numerous publications on stereotactic radiosurgery, intensity modulated radiation therapy (IMRT), and electronic brachytherapy. Dr. Bhatnagar is a leading physician who pioneered electronic brachytherapy for the treatment of skin cancer since its inception. Learn more about electronic brachytherapy in this video.

For more information about 21st Century Oncology, visit:

For more information about the Xoft System, visit:

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Dr. Ajay Bhatnagar MD (2015). Brachytherapy Offers Alternative Treatment of Difficult Non Melanoma Skin Cancer