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Purpose: To investigate whether single nucleotide polymorphisms (SNPs) in the ataxia telangiectasia mutated (ATM) gene are associated with survival in patients with esophageal squamous cell carcinoma (ESCC) receiving radiation therapy or chemoradiation therapy or surgery only.Methods and MateriaLs: Four tagSNPs of ATM were genotyped in 412 individuals with clinical stage Ⅲ or Ⅳ ESCC receiving radiation therapy or chemoradiation therapy, and in 388 individuals with stage Ⅰ, Ⅱ, or Ⅲ ESCC treated with surgery only.Overall survival time of ESCC among different genotypes was estimated by Kaplan-Meier plot, and the significance was examined by log-rank test.The hazard ratios (HRs) and 95% confidence intervals (CIs) for death from ESCC among different genotypes were computed by a Cox proportional regression model.Results: We found 2 SNPs, rs664143 and rs664677, associated with survival time of ESCC patients receiving radiation therapy.Individuals with the rs664143A allele had poorer median survival time compared with the rs664143G allele (14.0 vs 20.0 months),with the HR for death being 1.45 (95% CI 1.12-1.89).Individuals with the rs664677C allele also had worse median survival time than those with the rs664677T allele (14.0 vs 23.5 months), with the HR of 1.57 (95% CI 1.18-2.08).Stratified analysis showed that these associations were present in both stage Ⅲ and Ⅳ cancer and different radiation therapy techniques.Significant associations were also found between the SNPs and locosregional progression or progression-free survival.No association between these SNPs and survival time was detected in ESCC patients treated with surgery only.Conclusion: These results suggest that the ATM polymorphisms might serve as independent biomarkers for predicting prognosis in ESCC patients receiving radiation therapy.