To decrease skin dose and improve the build-up dose profile for megavoltage energies, it is recommended to:

Using suitable filters in the beam path is a common technique to manage dose distribution in radiation therapy, especially for megavoltage energies. Filters can help in modifying the energy spectrum of the incoming radiation, often flattening the dose profile and reducing the skin dose by preferentially attenuating lower-energy photons that contribute significantly to superficial skin doses.

In the context of megavoltage treatments where there is a concern for skin sparing, applying filters can enhance the therapeutic ratio by decreasing the dose received by the skin while ensuring adequate dose delivery to deeper tissues or tumors. This manipulation of the beam characteristics helps in achieving a more desirable dose distribution, particularly in the build-up region, which is essential for effective treatment planning and patient safety.

Options such as using bolus material, increasing beam energy, or reducing field size may serve specific purposes in certain treatment scenarios, but they might not effectively address the need to decrease skin dose while improving the build-up dose profile in the same manner as filters do. Bolus can increase skin dose and change dose profiles; increasing beam energy could lead to less skin sparing; and reducing field size may lead to underdosing the target area. Filters provide a precise, adaptable solution focused on enhancing dose delivery characteristics for megav