Investigation of the evolution of radiation-induced lung damage using serial CT imaging and pulmonary function tests

•Detailed RILD evolution described by objective radiological and pulmonary function measures.•RILD is associated with volume loss of the treated lung and contralateral lung hyperinflation.•Objective radiological findings might differentiate subjects with early versus late RILD.•Most patients developed progressive lung damage, even when the early phase is absent/mild.•Pre-RT lung function and RT dosimetry may identify subjects at increased risk of developing RILD.