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C. K. Bomford, Calculation of percentage depth dose in regions of build-up, British Journal of Radiology, Volume 42, Issue 499, 1 July 1969, Pages 551–552, https://doi.org/10.1259/0007-1285-42-499-551-b
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One of the significant differences frequently found between dose distributions for radiotherapy drawn up by hand and those produced by a computer is in the build-up region immediately below the skin surface. This letter shows that a valid correction is readily available for radiation energies in the range 2 MV to 31 MV and focus-skin distances of 75 cm to 100 cm.
In computer-assisted treatment planning, the build-up region of the beam of radiation is frequently ignored. This is because either (1) the empirical formula used to calculate the dose at depths greater than the peak does not accommodate the peculiarities which occur in the build-up region, or (2) the digitised isodose grid is not sufficiently detailed to offer any accuracy in this region.