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Radiation therapy today, on account of improvements in treatment procedures over the last 60 years, allows precise treatment of static tumors inside the human body. However, irradiation of moving tumors is still a challenging task as moving tumors often leave the treatment beam and the radiation dose delivered to the tumor reduces simultaneously increasing that on healthy tissue. This research work aims to push the frontiers of radiation therapy in order to enable precise treatment of moving tumors with focus on research and development of a unique real-time system enabling active motion compensation through robotic means to compensate tumor motion. During treatment, patients lie on a treatment couch which is normally used for static position corrections of patient set-up errors prior to radiation treatment. The treatment couch used, called HexaPOD, is a parallel manipulator with six degrees of freedom which can precisely position heavy loads inside a small region. Despite the HexaPOD not initially built with dynamics in mind, it is used in this work for sustained motion compensation by moving patients such that tumors stay precisely located at the center of the treatment beam during the complete course of treatment. In order to realize real-time tumor motion compensation by means of the HexaPOD, several challanges need to be addressed. Real-time aspects are covered by the adoption of a hard real-time operation system in combination with measurement and estimation of latencies of all physical quantities in the compensation system such as tumor or breathing position measurements. Accurate timing information is respected consistently in the whole system and all software-induced latencies are adaptively compensated for. This requires knowledge of future tumor positions from predictors. Several predictors for breathing and tumor motion predictions are proposed and evaluated in terms of a variety of different performance metrics. Extensions to prediction algorithms are introduced fusing both breathing and tumor position information to allow for predictions without the need of an explicit correlation model. Predictions determine the future motion path of the HexaPOD in order to compensate for tumor motion. Several control schemes are developed to enable reference tracking for the HexaPOD. Based on linear and non-linear dynamic modelling of the HexaPOD with system identification methods, a first controller is derived in the form of a model predictive controller. A second controller is proposed based on an assumption of the working principle of the HexaPOD's internal controller. Finally, a third controller is derived as combination of the first and second one. For each of these controllers, comparative results with real hardware experiments and humans in the loop as well as choices of free parameters are presented and discussed. Apart from precise tracking, emphasis is placed on patient comfort which is of crucial importance for acceptance of the system. It is demonstrated that smooth trajectories can be realized by the controllers to guarantee that patients feel comfortable while their tumor motion is compensated at sub-millimeter accuracies. Overall errors of the system are analyzed by relating them to tracking and prediction errors. By exploiting the properties of different predictors, it is shown that the startup time until tracking is reached can be reduced to only a few seconds, even in the case of an initially at-rest HexaPOD and with no initial knowledge of tumor motion. This makes the system especially suitable for the relatively short-fractionated treatment sessions for lung tumors. The tumor motion compensation system has been developed solely based on standard clinical hardware, found in most treatment rooms. With a simple and flexible design, existing treatment can be updated in a cost-efficient way to introduce motion compensation capabilities. Simultaneously, the system does not impose any constraints on state-of-the-art treatment types such as intensity modulated radiotherapy or volumetric modulated arc therapy. Supporting different compensation modes, the system can be applied to any moving tumor whether its motion is predictable (lung tumors) or unpredictable (prostate tumors). By integration of adequate tumor position determination methods, the system can be easily extended to other tumors as well.