In some embodiments, a method includes receiving, in a processor, information indicative of (i) a treatment plan defining planned treatment beams, (ii) a patient volume relative to a reference, (iii) ideal intersections of the planned treatment beams with the patient volume at the time the patient is to be treated, (iv) any constraints that prevent achievement of the recommended repositioning using only the patient support, (v) an allowable change to a gantry position from a planned value and an allowable change to a collimator position from a planned value; defining, in the processor, a plurality of alternatives based at least in part on the information indicative of any constraints of the patient support and the information indicative of allowable movement of the gantry and collimator, each alternative defining a modified patient support position and modified beams, each modified beam being based at least in part on a respective one of the planned treatment beams, the change to the position of the gantry for the respective planned treatment beam and the change to the position of the collimator for the respective planned treatment beam; determining, in the processor, for each modified beam of each alternative, an intersection of the patient volume and the modified beam, with the patient volume positioned on the patient support and the patient support having the modified patient support position defined by the alternative; and defining, in the processor, for each alternative, a measure of difference between the ideal intersections and the intersections for the modified beams of the alternative.