How would you approach treatment of an elderly patient with recurrent atypical fibroxanthoma (malignant spindle cell neoplasm) after Mohs surgery?

We published our experience of 8 cases of scalp atypical fibroxanthoma treated with XOFT 50 KeV photons as primary therapy. At 24 months, there was one failure which occurred in the only patient who was not debulked prior to radiation therapy.

Treating with low energy photons or electrons after the r...