What is your approach for, and in which situations would you use, an external boost in the management of gynecologic cancers?

The most important and consistent indication for external boosts is in the treatment of regional disease. In nearly all cases where there is evidence or suspicions of gross nodal involvement, we treat the sites of gross disease to at least 60 Gy, while areas of microscopic disease typically receive about 45 Gy. We also generally boost the initial locations of nodes that have responded to neoadjuvant chemotherapy, because our experience suggests that these can be sites of recurrence despite 45 Gy...