A brachytherapy applicator for treatment of metastic lesions in a load bearing region is provided. The applicator comprises an elongate tube body having a proximal and a distal end and defining an open internal area. A fixation element located on an outer portion of the tube allows the applicator to be fixed in position in relation to a target region while delivering a dose of therapeutic radiation. The fixation element can fix the applicator to tissue and/or a stabilization element implanted within a patient. A source of radiation positioned within the elongate body, before, during, or after implantation of the applicator, provides the therapeutic radiation.