Treatment adaptation in radiotherapy based on intra-fraction dosing

A non-transitory computer readable medium that includes a set of instructions which, in response to execution by a processor of a computer system, cause the processor to perform a method of radiotherapy for a plurality of locations within a region of patient anatomy, the method comprising:

• determining a first radiation dose that is delivered during a first time segment of a treatment fraction to a first location included in the plurality of locations, wherein the first radiation dose is based on a first machine state of a radiotherapy system associated with the first time segment and a first surface map of the region associated with the first time segment, wherein the first time segment has a duration on the order of a few milliseconds to tens of milliseconds;
• based on the first radiation dose, determining a dose error associated with the first location for the first time segment;
• based on the dose error, determining a second radiation dose to be delivered to the first location in a second time segment of the treatment fraction;
• based on the second radiation dose, changing a second machine state of the radiotherapy system associated with the second time segment to a third machine state of the radiotherapy system;
• and
• delivering the second radiation dose to the first location during the second time segment using the third machine state.