Insurance-covered in Japan — since September 2013 as an intraoperative treatment for primary malignant brain tumours Source: Japanese phase 2 trial and university hospital outcome papers
Glioblastoma photodynamic therapy (PDT) is an intraoperative treatment: a drug called talaporfin sodium is injected the day before surgery, and after the tumour is removed a 664 nm laser is shone on the cavity to target remaining cancer cells. In Japan it has been covered by health insurance for primary malignant brain tumours since September 2013, and a Japanese phase 2 trial reported a 1-year survival rate of 100% and a median overall survival of 24.8 months in 13 patients with newly diagnosed glioblastoma.
What is glioblastoma photodynamic therapy?
Glioblastoma is the most common and fastest-growing of the malignant tumours that start in the brain. Because it spreads into the surrounding normal brain tissue, cancer cells are easily left at the edge even after the visible part is removed. Photodynamic therapy targets exactly this “edge zone”.
Here is how it works. Talaporfin sodium is given once into a vein at 40 mg per m² of body surface area, 22–26 hours before surgery. The drug tends to collect more in tumour cells. After the tumour is removed, a 664 nm semiconductor laser is shone on the walls of the resection cavity. According to Tokyo Women’s Medical University, each circular spot 1.5 cm in diameter receives 27 J/cm², and spots are treated one after another without overlapping. The light-activated drug produces reactive oxygen that damages cancer cells.
Talaporfin was first approved in Japan in 2003 for early-stage lung cancer, and investigators at Tokyo Medical University applied the same principle to the invading edge of brain tumours. They describe it as “a tumor cell-selective less invasive therapy” that can be used even when a tumour has spread into functionally important brain areas.
Which patients can receive it?
In Japan, insurance covers its use in surgery for primary malignant brain tumours. It is used not only for newly diagnosed glioblastoma but also in repeat surgery for recurrent glioblastoma. Photodynamic therapy does not replace standard treatment; it is added to surgery, and standard treatment such as radiotherapy and the chemotherapy drug temozolomide follows after the operation.
For reference, in the 2005 international phase 3 trial (573 patients) that established today’s standard, patients who received radiotherapy plus temozolomide after surgery had a median overall survival of 14.6 months and a 2-year survival rate of 26.5%. The periods and patients differ, so this cannot be compared directly with the Japanese results below, but it gives a reference point.
What were the trial and hospital results?
An investigator-initiated phase 2 trial run jointly by Tokyo Women’s Medical University and Tokyo Medical University (May 2009 to March 2012) enrolled 27 patients, 22 of whom were included in the efficacy analysis. Results for the 13 patients with newly diagnosed glioblastoma are shown below, and insurance coverage followed in September 2013. Comparative results in recurrent glioblastoma have since been published as well.
| Study | Patients | Reported results |
|---|---|---|
| Japanese phase 2 (Muragaki 2013) | 13 with newly diagnosed glioblastoma | 1-year survival 100%, median overall survival 24.8 months, progression-free survival 12 months, progression-free survival at the irradiated site 20 months |
| Tokyo Women’s Medical University (Kobayashi 2022) | Repeat surgery for recurrent glioblastoma: 70 with PDT, 38 with surgery alone | Median overall survival 16.0 vs 12.8 months, 2-year survival 37.4% vs 11.5%, progression-free survival 5.7 vs 2.2 months |
Sources: Muragaki Y et al., J Neurosurg 2013;119:845-852 (figures as summarised in Akimoto J, Neurol Med Chir 2016;56:151-157) / Kobayashi T et al., Pharmaceutics 2022;14(2):353. The 2022 study is a single-hospital retrospective comparison.
In the recurrent glioblastoma study, the 1-year survival rate was 73% with photodynamic therapy (58.8% with surgery alone), and the difference in survival was statistically significant (p=0.031). The investigators concluded that “TS-PDT has significant prognostic value as an adjunct to surgery in treating recurrent GBM” and proposed confirming this in larger prospective studies.
How are side effects and light exposure managed?
- Side effects directly related to treatment: in the safety analysis of all 27 phase 2 participants, side effects directly related to photodynamic therapy were mild.
- Surgery-related complications: among 70 patients with recurrence, 3 (4.3%) had wound dehiscence, cerebrospinal fluid leakage or an epidural haematoma, treated with further surgery where needed. There was no statistical difference from the surgery-alone group (p=0.55).
- Light protection: while the drug remains in the body, the skin can be sensitive to light, so a period of staying indoors at 500 lux or less is needed. Skin sensitivity to talaporfin clears relatively quickly, so this period is about 2 weeks, shorter than with an older photosensitiser (about 1 month).
What is its status in Japan?
Talaporfin photodynamic therapy is an approved, insurance-covered treatment: in September 2013 Japan recognised it for health insurance coverage as a new intraoperative therapy for malignant brain tumours. Since then, post-marketing surveillance, treatment guidelines, training courses and safety information have been put in place. It is performed in neurosurgery departments with the laser equipment and training, so whether it is available for a particular patient is decided by the hospital and treating team.
Photoimmunotherapy for head and neck cancer is also a “light treatment”, but it is a separate treatment with a different drug and wavelength. Its outcomes are summarised in Head and neck cancer photoimmunotherapy results, and public information on light-based treatment in Japan is on our Photoimmunotherapy-related Information page.
What should I ask my doctor?
- Can photodynamic therapy be added during surgery for a tumour in my location? How far will the light be applied?
- How will radiotherapy and temozolomide follow after surgery?
- What should I be careful about in hospital and after discharge during the light-protection period?
- If the tumour recurs, can repeat surgery with photodynamic therapy be considered?
Frequently asked questions
Is glioblastoma photodynamic therapy covered by insurance in Japan?
Yes. In September 2013 talaporfin photodynamic therapy was recognised for Japanese health insurance coverage as an intraoperative treatment for primary malignant brain tumours.
Is glioblastoma treated with photodynamic therapy alone?
No. It is added to surgery, and standard treatment such as radiotherapy and temozolomide follows afterwards. The treatment plan is decided by the treating team.
How long must light be avoided after treatment?
According to Japanese investigators, with talaporfin about 2 weeks indoors at 500 lux or less is enough. Follow the treating hospital’s specific instructions for daily life.
Have results been reported for recurrent glioblastoma?
In a comparative study at Tokyo Women’s Medical University, the 70 patients who had repeat surgery with photodynamic therapy had a median overall survival of 16.0 months, longer than the 38 patients who had surgery alone (12.8 months).
Related: Head and Neck Cancer Photoimmunotherapy: Japan Approval and Results · Aptamer Cancer Drug Trial Results: Olaptesed Pegol Phase 1/2 · Same name “photoimmunotherapy”, not the same treatment
Sources
- Akimoto J. Photodynamic Therapy for Malignant Brain Tumors. Neurologia medico-chirurgica 2016;56(4):151-157
doi.org/10.2176/nmc.ra.2015-0296
Checked: 2026-10-18 - Muragaki Y et al. Phase II clinical study on intraoperative photodynamic therapy with talaporfin sodium and semiconductor laser in patients with malignant brain tumors. Journal of Neurosurgery 2013;119:845-852. DOI 10.3171/2013.7.JNS13415
pubmed.ncbi.nlm.nih.gov/23952800
Checked: 2026-10-18 - Kobayashi T, Nitta M et al. Therapeutic Options for Recurrent Glioblastoma—Efficacy of Talaporfin Sodium Mediated Photodynamic Therapy. Pharmaceutics 2022;14(2):353
mdpi.com/1999-4923/14/2/353
Checked: 2026-10-18 - Akimoto J, Fukami S, Ichikawa M, Mohamed A, Kohno M. Intraoperative Photodiagnosis for Malignant Glioma Using Photosensitizer Talaporfin Sodium. Frontiers in Surgery 2019;6:12
doi.org/10.3389/fsurg.2019.00012
Checked: 2026-10-18 - Stupp R et al. Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma. New England Journal of Medicine 2005;352(10):987-996
pubmed.ncbi.nlm.nih.gov/15758009
Checked: 2026-10-18
Written by the FTH editorial team. Sources checked 2026-10-18 · Medical review: not applicable
This article is general information based on public sources and does not replace diagnosis or treatment. Please discuss treatment decisions with your medical team.
