Clinical Resources
Xoft® Axxent® Electronic Brachytherapy (eBx®) System®
Clinical Resources
Advances in technology continually inspire healthcare leaders to identify and evaluate alternative technologies that expand and improve the treatment options they offer patients. A growing body of favorable clinical data supports the use of electronic brachytherapy (eBx) in patients meeting specific selection criteria. We are committed to furthering research of radiation therapy with the Xoft System for the treatment of multiple types of cancer.
Peer-Reviewed Data
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2018
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2011
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2009
Schwartzberg, Barbara S., et al. “Application of 21-Gene Recurrence Score Results and ASTRO Suitability Criteria in Breast Cancer Patients Treated with Intraoperative Radiation Therapy (IORT).” The American Journal of Surgery, 2018, https://doi.org/10.1016/ j.amjsurg.2018.07.022
Silverstein, Melvin J., et al. “Intraoperative Radiation Therapy (IORT): A Series of 1000 Tumors.” Annals of Surgical Oncology, Feb. 2018.
Patel, Rakesh, et al. “Lifetime Cost-Effectiveness Analysis of Intraoperative Radiation Therapy versus External Beam Radiation Therapy for Early Stage Breast Cancer.” Cost Effectiveness and Resource Allocation, Sept. 2017:15:22.
M. Silverstein, et al. Intraoperative Radiation Using Low-Kilovoltage X-Rays for Early Breast Cancer: A Single Site Trial. Ann Surg Oncol (2017): 1534-4681.
Lai, Hung-Wen, et al. “Multi-Center Study on Patient Selection for and the Oncologic Safety of Intraoperative Radiotherapy (IORT) with the Xoft Axxent® eBx® System for the Management of Early Stage Breast Cancer in Taiwan.” Plos One, 12(11):, Feb. 2017.
M. Silverstein, et al. “Acute and Chronic Complications in Patients with Ductal Carcinoma in Situ Treated with Intraoperative Radiation Therapy." The Breast Journal, 22(6):, Apr. 2016.
M. Silverstein, et al. “Acute and Chronic Complications in Breast Cancer Patients Treated with Intraoperative Radiation Therapy”. Ann Surg Oncol. 23(10):3304-9. 2016
Patel, Rakesh R., et al. “Postsurgical Treatment of Early-stage Breast Cancer With Electronic Brachytherapy Outcomes and Health-related Quality of Life at 1 Year”. Am J Clin Oncol. 2013 Oct;36(5):430-5.
Dooley, William, et al. “Electronic Brachytherapy as Adjuvant Therapy for Early Stage Breast Cancer: a Retrospective Analysis.” OncoTargets and Therapy, 2011, p. 13., doi:10.2147/ott.s15297.
Dooley, William C, et al. “Surgical Perspectives from a Prospective, Nonrandomized, Multicenter Study of Breast Conserving Surgery and Adjuvant Electronic Brachytherapy for the Treatment of Breast Cancer.” World Journal of Surgical Oncology, vol. 9, no. 1, 2011, p. 30., doi:10.1186/1477-7819-9-30.
Ivanov, Olga, et al. “Twelve-Month Follow-Up Results of a Trial Utilizing Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy for Early-Stage Breast Cancer.” Annals of Surgical Oncology, vol. 18, no. 2, 2010, pp. 453–458., doi:10.1245/s10434-010-1283-x.
Beitsch, Peter, et al. “Post-Surgical Treatment of Early-Stage Breast Cancer with Electronic Brachytherapy: an Intersociety, Multicenter Brachytherapy Trial.” OncoTargets and Therapy, 2010, p. 211., doi:10.2147/ott.s14514.
Mehta VK, et al. "Experience With an Electronic Brachytherapy Technique for Intracavitary Accelerated Partial Breast Irradiation." American Journal of Clinical Oncology (4:33) August 2010: 327–335.
Dickler A, et al. "Intraoperative Radiation Therapy in the Treatment of Early-Stage Breast Cancer Utilizing Xoft Axxent Electronic Brachytherapy." World Journal of Surgical Oncology (7) 2009: 24.
2017
2016
2015
2013
2010
Patel, Rakesh, et al. “Comparison of Electronic Brachytherapy and Mohs Micrographic Surgery for the Treatment of Early-Stage Non-Melanoma Skin Cancer: a Matched Pair Cohort Study.” Journal of Contemporary Brachytherapy, vol. 4, 2017, pp. 338–344., doi:10.5114/jcb.2017.68480.
Goyal, Uma, et al. “Does Ultrasound Measurement Improve the Accuracy of Electronic Brachytherapy in the Treatment of Superficial Non-Melanomatous Skin Cancer?” Journal of Contemporary Brachytherapy, vol. 1, 2017, pp. 14–19., doi:10.5114/jcb.2017.65476.
Likhacheva, Anna O., et al. “Skin Surface Brachytherapy: A Survey of Contemporary Practice Patterns.” Brachytherapy, vol. 16, no. 1, 2017, pp. 223–229., doi:10.1016/j.brachy.2016.10.006.
Doggett, Stephen, et al. “Electronic Brachytherapy Management of Atypical Fibroxanthoma: Report of 8 Lesions.” Journal of Contemporary Brachytherapy, vol. 2, 2017, pp. 158–160., doi:10.5114/jcb.2017.65454.
Massat MB. “Electronic brachytherapy for skin cancer: Problems and progress.” Appl Rad Oncol. 2017;6(2):24-25.
Goyal, Uma, et al. “The Feasibility of Using Ultrasound during Follow-up for Superficial Non-Melanoma Skin Cancers after Electronic Brachytherapy.” Journal of Contemporary Brachytherapy, vol. 9, no. 6, 2017, pp. 535–539., doi:10.5114/jcb.2017.72358.
A. Bhatnagar, et al. “High-dose Rate Electronic Brachytherapy: A Nonsurgical Treatment Alternative for Nonmelanoma Skin Cancer”. The Journal of Clinical and Aesthetic Dermatology; Nov. 2016; Vol. 9; No.11
Delishaj, Durim, et al. “Non-Melanoma Skin Cancer Treated with High-Dose-Rate Brachytherapy: a Review of Literature.” Journal of Contemporary Brachytherapy, vol. 6, 2016, pp. 533–540., doi:10.5114/jcb.2016.64112.
Paravati, Anthony J., et al. “Clinical and Cosmetic Outcomes in Patients Treated with High-Dose-Rate Electronic Brachytherapy for Nonmelanoma Skin Cancer.” Practical Radiation Oncology, vol. 5, no. 6, 2015, doi:10.1016/j.prro.2015.07.002.
Doggett, Stephen et al. “Incorporation of Electronic Brachytherapy for Skin Cancer into a Community Dermatology Practice.” The Journal of Clinical and Aesthetic Dermatology 8.11 (2015): 28–32.
Arterbery, V Elayne, and Alice C Watson. “An Electronic Brachytherapy Technique for Treating Squamous Cell Carcinoma in Situ of the Digit: A Case Report.” BMC Research Notes 6 (2013): 147. PMC. Web. 4 Sept. 2018.
Bhatnagar, Ajay. “Nonmelanoma Skin Cancer Treated with Electronic Brachytherapy: Results at 1 Year.” Brachytherapy, vol. 12, no. 2, 2013, pp. 134–140., doi:10.1016/j.brachy.2012.08.003.
Bhatnagar, Ajay, and Alphonse Loper. “The Initial Experience of Electronic Brachytherapy for the Treatment of Non-Melanoma Skin Cancer.” Radiation Oncology, vol. 5, no. 1, 2010, p. 87., doi:10.1186/1748-717x-5-87.
2019
2018
2013
2010
Lozares-Cordero, Sergio, et al. “Treatment of cervical cancer with electronic brachytherapy.” J Appl Clin Med Phys. doi:10.1002/acm2.12657
Lozares-Cordero, Sergio, et al. “Postoperative Endometrial Cancer Treatments with Electronic Brachytherapy Source.” Journal of Radiotherapy in Practice, pp. 1–5., doi:10.1017/S1460396918000353.
Kamrava, Mitchell, et al. “Electronic Brachytherapy for Postsurgical Adjuvant Vaginal Cuff Irradiation Therapy in Endometrial and Cervical Cancer: A Retrospective Study.” Brachytherapy, vol. 12, no. 2, 2013, pp. 141–147., doi:10.1016/j.brachy.2012.04.003.
Dickler, Adam, et al. “Prospective Multi-Center Trial Utilizing Electronic Brachytherapy for the Treatment of Endometrial Cancer.” Radiation Oncology, vol. 5, no. 1, 2010, p. 67., doi:10.1186/1748-717x-5-67.
Dooley, William. “Use of Electronic Brachytherapy to Deliver Postsurgical Adjuvant Radiation Therapy for Endometrial Cancer: a Retrospective Multicenter Study.” OncoTargets and Therapy, 2010, p. 197., doi:10.2147/ott.s13593.
2018
2012
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2006
Li Heng Liang, et al. “Physics aspects of the Papillon technique—Five decades later.” Brachytherapy, vol. 17, no.1, 2018, pp. 234-243., doi.org/10.1016/j.brachy.2017.09.016.
Richardson, S., et al. “Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source.” Med. Phys., 39: 6838-6846. doi:10.1118/1.4757915
Ahmad, S, et al. "Comparison of Tumor and Normal Tissue Dose for Accelerated Partial Breast Irradiation Using Electronic Brachytherapy eBx source and an Iridium-192 source." J Appl Clin Med Phys (11:4) 2010: 155–161.
Rong, Yi, and James S. Welsh. “Surface Applicator Calibration and Commissioning of an Electronic Brachytherapy System for Nonmelanoma Skin Cancer Treatment).” Medical Physics, vol. 37, no. 10, 2010, pp. 5509–5517., doi:10.1118/1.3489379.
Hepel JT, et al. "Modeling Study for Optimization of Skin Dose for Partial Breast Irradiation Using Xoft Axxent Electronic Brachytherapy Applicator." Brachytherapy (9) 2010: 81–85.
Mille MM, Xu XG. "Comparison of Organ Doses For Patients Undergoing Balloon Brachytherapy of The Breast With HDR 192Ir or Electronic Sources Using Monte Carlo Simulations in a Heterogeneous Human Phantom." Medical Physics (37) 2010: 662–671.
Sternick E, et al. "Intensity Modulated Electronic Brachytherapy Will Soon Become The Brachytherapy Treatment of Choice For Irregularly Shaped Tumor Cavities or Those Closely Bounded by Critical Structures." Medical Physics (36) 2009: 681–683.
Holt RW, et al. "Mini-X-ray Tubes Will Ultimately Displace Ir-192 as The Radiation Source for High Dose-Rate Brachytherapy." Medical Physics (35) 2008: 815–817.
Reniers B, et al. "Calculation of RBE of a Low-Energy Electronic Brachytherapy Source." Physics in Medicine and Biology (53) 2008: 7125–7135.
Mahesh M, et al. "Electronic Brachytherapy: Comparisons With External Beam and High Dose-Rate 192Ir Brachytherapy." Journal American College Radiology (5) 2008: 221–223.
Hiatt JR, et al. "A Commissioning Procedure for Breast Intracavitary Electronic Brachytherapy Systems." Journal of Applied Clinical Medical Physics (9) 2008: 58–68.
Dickler A, et al. “Dosimetric Comparison of Xoft Electronic Brachytherapy and Ir-192 HDR Brachytherapy In the Treatment of Endometrial Cancer”. Brachytherapy 2008; 7;351-354.
Liu D, et al. "Spectroscopic Characterization of a Novel Electronic Brachytherapy System." Physics in Medicine and Biology (53) 2008: 61–78.
Dickler, et al. "A Dosimetric comparison of MammoSite high dose rate brachytherapy and Xoft Axxent electronic brachytherapy," Brachytherapy (6) 2007, 164-168.
Smitt MC, et al. "Dose Volume Characteristics of a 50kV Electronic Brachytherapy Source For Intracavitary Accelerated Partial Breast Irradiation." Brachytherapy (6) 2007: 207–211.
Rivard M, et al. "Calculated and Measured Brachytherapy Dosimetry Parameters For The Xoft Axxent X-Ray Source: An Electronic Brachytherapy Source." Medical Physics (33) 2006: 4020–4032.
2021
Study: Prospective comparative study of intraoperative balloon electronic brachytherapy versus resection with multidisciplinary adjuvant therapy for recurrent glioblastoma. Published October 2021
Erratum: Prospective comparative study of intraoperative balloon electronic brachytherapy versus resection with multidisciplinary adjuvant therapy for recurrent glioblastoma. Published December 2021
Clinical Abstracts
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2018
2017
2016
2015
2014 and older
A. M. Nisar Syed, et al. Technique and Preliminary Results of a Multi-Center Trial of Intra-Operative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conserving Surgery for Early Stage Breast Cancer. Presented at ASTRO 2018.
Lozares, et al. Comparison of Axxent electronic brachytherapy with Mammo site system in breast treatments for skin, lung and heart dose. Presented at IUPESM 2018.
Gutiérrez, et al. IORT For Breast Cancer Treated with Axxent Xoft. Our Experience Toxicity Analysis. Presented at ESTRO37
Lozares, et al. Breast Treatments with Axxent Equipment. Comparison with Mammo site for Skin, Lung and Heart Dose. Presented at ESTRO37
B. Schwartzberg, et al. Prognostic Benefit of American Joint Commission on Cancer (AJCC) 8th Edition (Ed) Breast Cancer Pathological Prognostic Stage Group in Patients (pts) treated with Intraoperative Radiation Therapy (IORT) at a Single Institution in Denver, Colorado. Presented at MBCC 2018.
C. Coomer, et al. Recurrence Rates for Intraoperative Radiation Therapy in Stage 0 and Stage 1 Breast Cancer: Experience eat a Single Institution over a 3 year period. Presented at MBCC 2018.
A. M. Nisar Syed, et al. A multi-center trial of intra-operative electronic brachytherapy during breast conservation surgery for early stage breast cancer: early results of unplanned boost participants. Presented at NCoBC 2018.
A. M. Nisar Syed, et al. Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early Stage Breast Cancer: Early Follow-up Results of a Non-randomized, Multicenter Trial. Presented at ASTRO 2017.
A. M. Nisar Syed, et al. Self-reported Quality of Life in Early-stage Breast Cancer: An Ongoing Multicenter Trial of Intra-operative Electronic Brachytherapy During Breast Conservation Surgery. Presented at ASTRO 2017.
A.Crown, et al. Intraoperative Radiation Therapy A Treatment Option for Patients with Invasive Cancer. Presented at ASBS 2017.
E. Carlson, et al. Intraoperative radiotherapy for management of ductal carcinoma in situ of the breast: a single center experience. Presented at ASBS 2017.
G. Proulx, et al. Intraoperative Radiation (IORT) as Adjuvant Radiation Monotherapy for Early-Stage Breast Cancer Patients Treated with Breast Conserving Surgery. Presented at ABS 2017.
I. Carreras, et al. Intraoperative Radiation Therapy (IORT) for Breast Cancer Treated with Xoft® System. Our Experience. Presented at Milan Breast 2017.
I. Carreras, et al. Intraoperative Radiotherapy in Breast Cancer with Xoft® System. Study of Parameters Related With Skin Acute Toxicity. Presented at Milan Breast 2017.
A.M. Nisar Syed. et al. Two-year Follow-up Results of a Multi-center Trial of Intra-operative Electronic Brachytherapy During Breast Conservation Surgery for Early Stage Breast Cancer. Presented at SABCS 2016.
A.M. Nisar Syed. et al. Multi-center Trial of Intra-operative Electronic Brachytherapy During Breast Conservation Surgery for Early Stage Breast Cancer: Early Results of Unplanned Boost Participants. Presented at SABCS 2016
A.M. Nisar Syed, et al. Early Results of a Multi-Center Trial of Intra-Operative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early Stage Breast Cancer. Presented at ASTRO 2016.
P. Costa, et al. Early Results of a Multi-Center Trial of Intra-Operative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early Stage Breast Cancer. Presented at ESTRO 2016.
A.M. Nisar Syed, et al. Feasibility and Early Outcomes of a Multi-Center Trial Of Intraoperative Radiation Therapy Using Electronic Brachytherapy At The Time Of Breast Conservation Surgery For Early Stage Breast Cancer. Presented at ASTRO 2015.
A. Dickler, et al. Five-Year Results of a Multi-Center Trial Utilizing Xoft Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy in the Treatment of Early-Stage Breast Cancer. Presented at ASTRO 2015.
A.M. Nisar Syed, et al. Feasibility and Early Outcomes of a Multi-Center Trial of Intra-Operative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early Stage Breast Cancer. Presented as snap oral presentation at ABS 2015.
A.M. Nisar Syed, et al. One-year Follow-up Results of a Multi-Center Trial of Intraoperative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early Stage Breast Cancer. Presented at SABCS 2015.
A Dickler, et al. Initial Results of a Multi-center Trial Utilizing Xoft Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy in the Treatment of Early-stage Breast Cancer.
P. Costa, et al. Early Breast Cancer Treated with Electronic Intraoperative Radiotherapy System (IORT): Report of the First Patients Treated in Portugal. Presented at ISIORT 2014.
APBI: RSNA preliminary report of 44-patient study results
Mehta, VK. "Early Experience With an Electronic Brachytherapy Technique for Intracavitary Partial Breast Irradiation." RSNA 2009: Abstract.
APBI: ASCO Breast Cancer Symposium—Preliminary report of 44-patient study results
Mehta V, Dooley W, Greim K, et al. "Early Experience With an Electronic Brachytherapy Technique for Intracavitary Partial Breast Irradiation." ASCO Breast Cancer Symposium 2008; Poster presentation December 2008.
2017
2016
2015
2014
Patel, et al. Comparison of electronic brachytherapy and Mohs micrographic surgery for the treatment of early-stage non-melanoma skin cancer: a matched pair cohort study. Best of ASTRO 2017.
N. Flores, et al. Peri-ocular non-melanoma skin cancers: Outcome in 86 cases treated with High Dose Rate Electronic Brachytherapy. Presented at ASTRO 2017.
A. Bhatnagar. Clinical Outcomes and Patient Reported Outcomes Following Electronic Brachytherapy for the Treatment of Non-Melanoma Skin Cancer. Presented at ASTRO 2016.
N. Flores. Peri-ocular non-melanoma skin cancers: Outcome in 62 cases treated with High Dose Rate Electronic Brachytherapy. Presented at AAD 2016.
A. Bhatnagar. Electronic Brachytherapy for the Treatment of Non-Melanoma Skin Cancer: Results up to 5 Years. Presented at ASTRO 2015.
P. Sanghvi. Clinical and Cosmetic Outcomes in Patients Treated With High Dose Rate Electronic Brachytherapy for Nonmelanoma Skin Cancer. Presented at ASTRO 2015.
R. Strimling, et al. Long-Term Follow-up of Patients with Non-melanoma Skin Cancer (NMSC) Lesions Treated with Electronic Brachytherapy. Presented at the Fall Clinical Dermatology Conference 2015.
S. Doggett, et al. Electronic Brachytherapy for Non-Melanomatous Skin Cancer: Report of First 565 Lesions. Presented at AAD 2015.
R. Strimling, et al. Initial Experience of Electronic Brachytherapy for the Treatment of 494 Non-melanoma Skin Cancer (NMSC) Lesions in 297 Patients. Presented at AAD 2015.
A. Bhatnagar. Electronic Brachytherapy for the Treatment of Non-Melanoma Skin Cancer: Results up to 4 Years. Presented at AAD 2015.
S. Doggett, et al. Electronic Brachytherapy for Non-Melanomatous Skin Cancer: Report of Failures and Adverse Events; Annual Follow-Up Report of First 565 Lesions. Presented as snap oral presentation at ABS 2015.
R. Patel, et al. A Multi-Center Report of Non-Surgical Treatment of Non- Melanomatous Skin Cancer with HDR Electronic Brachytherapy. Presented as snap oral presentation at ABS 2015.
R. Patel, et al. Initial Experience with Electronic Brachytherapy for Skin Cancer: Clinical and Dosimetric Comparisons. Presented at ABS 2015.
S. Doggett. Electronic Brachytherapy Management of Atypical Fibroxanthoma: Report of 7 Cases.
A. Bhatnagar. Electronic Brachytherapy for the Treatment of Non-Melanoma Skin Cancer: Results up to 4 Years. Presented at ASTRO 2014.
R. Strimling, et al. Initial Experience of Electronic Brachytherapy for the Treatment of 508 Non-melanoma Skin Cancer (NMSC) Lesions in 305 Patients. Presented at the Fall Clinical Dermatology Conference 2014.
S. Doggett. Electronic Brachytherapy for Non-Melanomatous Skin Cancer:Report of First 561 Lesions.
S. Doggett, et al. Electronic Brachytherapy for Non-Melanomatous Skin Cancer: Report of First 561 Lesions.
2018
2017
2014
2013
Lozares, et al. Comparison of electronic brachytherapy with Ir192 for image-guided treatment for cervical cancer in two different centres. Presented at IUPESM 2018.
Villamon, et al. Toxicity Results After Treatment with Electronic Brachytherapy in Patients with Endometrial Cancer. Presented at ESTRO37
Lozares, et al. Comparison of brachytherapy sources of endometrial cancer Electronic brachytherapy source and 192Ir. Presented at ESTRO36
Villamon, et al. Acute toxicity results after treatment with Xoft Axxent Electronic Brachytherapy (XB) in patients with endometrial or cervical cancer. Presented at ESTRO36
Lozares, et al. Dosimetric Comparison of Brachytherapy Sources for High Dose Rate Treatment of Endometrial Cancer: Electronic Brachytherapy,192Ir and 60Co Sources. Presented at AAPM 2017.
Thompson, J, Feasibility of Cervical Brachytherapy with a Novel 50 kV Electronic Brachytherapy Source. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
JS Thompson, et al. First report of using a 50 kV electronic-source brachytherapy for cervical cancer and was accomplished with acceptable dosimetry and clinical tolerability. Presented at ASTRO 2013.
2017
Krivoshapkin A., et al. “Maximal safe resection followed by balloon electronic brachytherapy for recurrent glioblastomas and brain metastases.” Presented at EANS 2017.
Case Study
Leading global centers select the Xoft System for treatment of early-stage breast cancer
Multiple factors including clinically-proven efficacy, shorter treatment time, greater flexibility, easy portability and lower cost drive adoption
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White Paper
HDR Electronic Brachytherapy
A Non-surgical Treatment Alternative for Non-melanomatous Skin Cancer
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