Methods and systems of operating a support structure and beam shaping mechanism in a manner that compensates for motion patterns exhibited by a patient, promotes comfort of the patient, and optimizes accuracy of delivery of radiotherapy to a targeted location within the patient. The support structure can be a treatment table or couch and the beam shaping mechanism can be a multi-leaf collimator (MLC), and/or an MLC-bank/-carriage. The control system can utilize algorithms for predicting tumor motion and loading condition on the table/couch during radiation therapy.
