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Surface dose in megavoltage photon radiotherapy has a significant clinical impact on the skin-sparing effect. In previously published works, it was established that the presence of medium atomic number (Z) absorbers, such as tin, decreases the surface dose. It was concluded that high-Z absorbers, such as lead, increase the surface dose, relative to medium-Z absorbers, due to the increased contributions from photoelectrons and electron-positron pairs.
Khan et al. (Mon,) studied this question.