ABSTRACT Aim: There is an increasing number of older patients diagnosed of locally advanced head and neck cancer (LA-HNC) due to the growing life expectancy. The aim of this study is to assess the suitability of bio-chemoradiation therapy (BCRT) for these patients. Methods: This multicenter retrospective study was performed in four Spanish hospitals. LA-HNC patients ≥ 70 years (ys) treated between January 2009 and December 2011 were included. Demographics, comorbidity, treatment strategies and mortality were recorded. Results: Sixty-one patients were included (median age, 74.1 ys; range, 70-88; male, 74%; ECOG PS 0-1, 86.4%; stage IVA/IVB, 72%; recurrent disease, 11.5%). Forty-eight percent of subjects had ≥ 2 comorbidities (hypertension 51%; diabetes 21%; myocardial ischemia 15%; bronchopathy 33%, chronic renal insufficiency 25%, hepatopathy 5%). Primary tumor site was: oral cavity 34%; larynx 30%; oropharynx 23%; others 13%. Most of the aged (71%) were treated with radical concomitant BCRT (16% of them had received induction chemotherapy); 28% underwent surgery with adjuvant CRT. The schedules of BCRT were Cetuximab 38 (62.3%), triweekly Cisplatin 15 (24.6%) and others 8 (13.1%). The majority was able to complete all planned treatment (84% radiotherapy; 72% BCT). Complete and partial responses rates were 54% and 18% respectively. Number of comorbidities did not influence the election of BCRT. Nevertheless, ECOG PS ≥ 2 and age > 80 ys were related with cetuximab preference. There were 30 deaths: 21 from neoplasia, 1 from treatment complications (pneumonia). At 27 months' follow-up, 18 relapses and 6 second neoplasms were observed; 49% of the patients were alive (median overall survival 42 m). ACUTE TOXICITIES N % HEMATOLOGIC ≥ 3 6 9.8 MUCOSITIS ≥ 3 19 31.1 RASH ≥ 3 5 8.2 INFECTIONS 9 14.8 RENAL FAILURE 7 11.5 ADMISSION TO HOSPITAL 16 26.2 Conclusions: Elderly patients with LA-HNC benefit from radical multidisciplinary treatment. We still have to improve the rate of treatment compliance and reduce the toxicities, including a better election of BCRT schedule, taking into account comorbidities, PS and special needs (social, nutritional …) of this group of patients. Disclosure: All authors have declared no conflicts of interest.