HI there... Paul B here I believe has Tomo therapy so he might be able to answer your questions.

IMRT is still the gold standard, but a few hospitals are trying Tomo. Sorry to hear about your daughter. It's a bizarre disease.

I do think the cause of your daughter's disease is different than for your nephew. traditionally tonsil cancer is HPV related. Because it is caused by a virus it responds better to radiation and chemo.

I'd be willing to bet your daughter's cancer (same as mine) was not HPV related. Usually the first line of treatment is surgery as you describe followed by radiation and chemo. Unfortunately this cancer can be highly aggressive, and a whole host of factors come into play when looking at outcome.

skill of the surgeon, hospital, overall health, are just a few.

Hugs and blessings to you. I don't envy you going through this again.