A therapy system (10) includes one or more processors (98, 100). The processor (98, 100) is programmed to receive one or more of: (1) from a dosimeter (26, 28, 202, 204, 206, 208, 210, 212) dosimetry data; and (2) motion data from a surrogate (18, 20, 22, 24) implanted in the patient. Based on the movement data, a current position and / or shape of the surrogate (18, 20, 22, 24) is determined, and a deviation between the current position and / or shape and a reference position and / or shape is determined. Based on the dosimetry data, the delivered dose distribution is compared with the planned dose distribution and deviations therebetween are determined. Deviations determined from the motion data and / or the dosimetry data are used for adaptive planning, alignment, post-treatment analysis and safety.