INTRODUCTION: The standard adjuvant treatment in fit patients with glioblastoma multiforme is chemo-radiotherapy. However, this may be inappropriate in older patients, or those with a low Karnofsky Performance Score (KPS). Hypo-fractionated radiotherapy (30 Gy in 6 fractions over 2 weeks) is an alternative approach for this group. Nevertheless, the prognosis remains poor, so early palliative care input and effective communication between secondary and primary care is essential. This study was designed to assess whether the palliative intent of treatment and prognosis were being discussed and documented adequately. The clinical progress and treatment of patients post-radiotherapy was also determined. METHODS: Patients were identified who had been diagnosed with glioblastoma multiforme, between the years 2006-2013, and subsequently treated with hypo-fractionated radiotherapy in Leeds. Patient demographic data, performance status, date of tissue diagnosis and death, if applicable, were recorded. Surgical procedures and chemotherapy were also noted. Initial clinic letters after diagnosis were used to assess communication with patients and their general practitioners. RESULTS: A total of 114 patients were identified. The majority of patients were male (78; 68%) and of white British origin (110; 96%). The median age at diagnosis was 64 (Min 29, Max 83) years. Median survival was 6.8 (IQR: 4.4-10.0) months from date of diagnosis, with 19 (16%) surviving to 1-year. All but one patient received a tissue diagnosis, with 85 (73%) patients receiving debulking surgery. The survival difference between those who had debulking surgery and biopsy was 7.2 (5.1-11.3) and 6.1 (3.9-8.4) respectively (p = 0.108). Median time between tissue diagnosis and radiotherapy was 34 (27-42) days. 17 (15%) patients subsequently received palliative chemotherapy. The palliative intent of treatment was communicated to the patient and GP in 93 (82%) initial clinic letters. Prognosis was discussed and documented in 45 (39%) consultations, but only 23 (20%) communicated this to the GP. Resuscitation status was never documented. Performance score was recorded in 73 (64%) initial letters. The palliative nature of the treatment was reiterated to 70 patients, however only 15 had prognosis documented. Twenty-five (22%) patients did not attend a post-radiotherapy clinic, with a further 25 (22%) not returning after their first post-radiotherapy visit. At the last attended clinic before a patient's death, 57 (50%) patients had a further clinic appointment booked. CONCLUSION: We found that nearly a quarter of patients never returned to clinic after their radiotherapy and nearly a half only returned once. Ensuring the patient and GP are aware of the possible prognosis and palliative intent of treatment is essential to allow adequate end-of-life care planning.