anaplastic astrocytomas are progressive brain tumors with a tendency to infiltrate the surrounding tissue . recurrence is very common , with recurrent tumors being extremely refractory to existing therapies .
case presentation : a 33-year - old woman presented with a history of an unprovoked fall , followed by seizures .
an mri scan revealed a mass in the fronto - temporo - parietal region of the brain , suggesting a primary tumor .
follow - up mri scans indicated the presence of a residual , rapidly progressing tumor .
a 6-week course of fractionated radiation and concurrent chemotherapy with temodar ( temozolomide capsules ) did not stop tumor progression .
intervention : due to the failure of conventional therapies in preventing rapid disease progression , the patient volunteered to undergo a 28-day course of sequentially programmed magnetic field ( spmf ) therapy .
immediate post - therapy mri scan showed a cessation of tumor growth , and follow - up imaging at 6 , 12 , 24 and 36 months revealed a gradual but steady decrease in the size of the tumor .
the patient reported an alleviation of clinical symptoms and a subjective improvement in the quality of life at 6 , 12 , 24 and 36 months following spmf therapy .
the remarkable improvement of this patient suggests that spmf therapy may be a valuable option for anaplastic astrocytoma , especially in recurrent and rapidly progressing tumors .
anaplastic astrocytomas are pathologically classified by who as grade iii tumors that demonstrate pleomorphism , increased mitosis and vascular proliferation , with a characteristic absence of necrosis seen in glioblastomas .
the currently accepted treatment modality for such tumors is surgical debulking , followed by external beam radiation and adjuvant chemotherapy .
however , due to the nature of the tumor , a complete surgical resection is almost impossible .
the prognosis is highly variable and dependent on the age of the patient , symptom duration , karnofsky performance status , extent of resection , dose of radiation and several other factors .
also , recurrence is extremely common , with subsequent tumors being highly refractory to further therapy .
anaplastic astrocytomas , in particular recurrent tumors , clearly have an unfavorable prognosis , affirming the need to explore new therapeutic modalities .
sequentially programmed magnetic field ( spmf ) therapy is based on the principle that exposure to sequentially programmed electromagnetic fields can suppress tumor growth . the magnetic fields are delivered by a spmf machine that consists of multiple magnetic field generators arranged in a circular fashion around the gantry . the fields from these generators are focused on the centre of the affected tissue with the aid of laser guides .
the spmf machine generates sequential pulsed magnetic fields of < 30 milli - tesla in the range of 10 - 1,000 hz .
the field strength that the machine delivers is within the international commission for non - ionizing radiation protection 's safety norms .
a study assessing the spmf therapy for terminally ill cancer patients showed appreciable pain relief and improvement in karnofsky performance scores in 80% of the cases .
the failure of conventional modalities of treatment in preventing rapid tumor progression substantiated the use of spmf therapy in the current study subject .
a 33-year - old woman presented at the emory adventist hospital , atlanta , ga .
, usa , in october 2005 with a history of an unprovoked fall , followed by seizures a few hours later .
a ct scan of the brain revealed a large mass in the right fronto - temporo - parietal region involving the basal ganglia , with features suggestive of a primary tumor .
the patient underwent a right craniotomy with debulking of the tumor at the wellstar cobb hospital , atlanta , ga .
, usa . an aggressive parieto - frontal resection was done , and tumor tissue , roughly measuring 4  5  5 cm , was removed .
histopathological examination of the specimen revealed an astrocytoma with increased cellularity and the presence of mitotic figures , but without any evidence of necrosis or endothelial hyperplasia .
the histological features were consistent with the diagnosis of an anaplastic astrocytoma ( who grade iii ) .
a post - surgical mri scan revealed a persistent nodular enhancement within the right temporal lobe posterior to the resection cavity , suggesting residual disease in this location .
she was administered 34 fractions of 180 centigray ( cgy ) over a 7-week period , and prescribed 105 mg temodar ( temozolomide capsules ) daily for 45 days .
this was followed by a 5-day course of high - dose temodar ( 300 mg ) one month after the completion of the initial cycle .
monthly follow - up investigations indicated the presence of a progressive tumor with increasing enhancement and edema .
pet scan showed a hypometabolic lesion but magnetic resonance spectroscopy showed that the lesion was progressing and the patient was advised to undergo a second surgery for decompression .
the patient refused surgery and opted for spmf therapy at the institute of aerospace medicine ( iam ) , indian air force , bangalore , india . at the time of admission in june 2006 , the patient complained of tingling in the lower half of the left side of the face and left extremities , with some loss of recent memory .
an mri taken before starting the spmf therapy showed a mass in the right fronto - tempero - parietal region measuring 3.82  2.3  2.32 cm ( antero - posterior x transverse x supero - inferior ) . based on the mri findings
, the fields from the magnetic field generators were adjusted to focus on the centre of the tumor .
the therapy was given for 1 hour , daily , usually at a fixed time , for 28 consecutive days .
an mri scan taken on completion of the therapy showed a marginal reduction in mass ( 3.42  2.19  2.19 cm ) , along with some reduction in the thickness of the peripherally enhancing component .
the patient had subjective signs of recovery , with an improvement in memory and a complete alleviation of the tingling sensation in the lower half of the left side of the face and left extremities .
the mri scans performed 6 months after spmf therapy showed a reduction in the size of the lesion ( 2  2  1.3 cm ) , as well as a corresponding decrease in the thickness of the peripherally enhancing component and perilesional edema .
follow - up mri scans at 12 , 24 and 36 months after the spmf therapy demonstrated a progressive decrease in the lesion size ( fig .
pet scans at 12 , 24 and 36 months confirmed that the tumor had become metabolically inactive .
the radiological responses were mirrored by similar improvements in subjective assessment . the functional assessment for cancer therapy 
general ( fact - g ) scores improved dramatically at 6 months post - therapy and were maintained at 12 and 24 months ( table 1 ) .
corresponding changes were also seen with the karnofsky performance status , with scores of 70 , 80 and 100 during pre - spmf , immediate post - spmf and 6 months post - spmf therapy periods , respectively .
a score of 100 was maintained at 12 , 24 and 36 months post - therapy .
several studies have demonstrated the efficacy of magnetic fields in preventing neoplastic progression in cancer cell lines and animal models .
prostate cancer cell lines exposed to 60 hz sinusoidal magnetic field have demonstrated increased apoptosis and cell cycle arrest ; the effect being mediated by the generation of reactive oxygen species .
gastric adenocarcinoma cell lines treated with magnetic fields have shown a significantly higher incidence of apoptosis in comparison to untreated cells .
exposure of mice mammary adenocarcinoma cells to pulsating magnetic fields was reported to cause a reduction in vascularization and an increase in tumor necrosis .
similarly , mice with breast cancer xenografts exposed to pulsed magnetic fields were observed to have less lung metastasis and slower growth of tumors compared to sister controls .
static magnetic fields , produced by nuclear magnetic resonance spectroscopy , induced apoptosis in tumor cells of hematopoietic origin due to an increase in cytosolic calcium .
such a response was not seen in normal mononuclear white blood cells exposed to the same magnetic fields .
studies have also demonstrated that electromagnetic fields cause anti - tumor activity and a significant increase in apoptosis in tumors of treated animals , together with reduction in immunoreactive p53 expression .
the cells can divide only a defined number of times and then perish ( hayflick limit ) . with each mitotic cycle , they lose one molecule in the cytoplasm , such that the daughter cell contains one molecule less than the mother cell . microtubules and centrioles have their endogenous electromagnetic fields and can condense this energy required for transport of ions and organelles and duplication of centrioles during mitosis [ 14 , 15 ] . in cancer , these electromagnetic fields are aberrant , which can be normalized by exposure of these cancer cells to spmf therapy .
it is a well - known fact that the cell membrane potential of cancer cells is about 15 mv to 30 mv .
exposure of cancer cells to spmf will normalize this potential , thereby halting the process of cell proliferation .
a cascade of effects follows normalization of cell membrane potential , such as an increased influx of calcium , potassium and magnesium ions and efflux of sodium and water out of cells , and reduction in intracellular acidity [ 16 , 17 ] .
the frequencies and field strength used in spmf therapy are well within the specified norms of the international commission for non - ionizing radiation protection .
the previous studies conducted at the iam have shown that spmf therapy is a safe treatment modality [ 6 , 7 ] .
the efficacy of spmf therapy in this patient with a rapidly progressing anaplastic astrocytoma demonstrates the enormous potential of this new treatment modality . considering the poor prognosis of anaplastic astrocytoma grade iii with standard modalities of treatment
, spmf holds promise to improve overall survival and quality of life non - invasively .
 backgroundanaplastic astrocytomas are progressive brain tumors with a tendency to infiltrate the surrounding tissue . recurrence is very common , with recurrent tumors being extremely refractory to existing therapies . 
 case presentation : a 33-year - old woman presented with a history of an unprovoked fall , followed by seizures . 
 an mri scan revealed a mass in the fronto - temporo - parietal region of the brain , suggesting a primary tumor . 
 she underwent craniotomy and surgical debulking of the tumor . 
 the histology of the tumor tissue revealed an anaplastic astrocytoma . 
 follow - up mri scans indicated the presence of a residual , rapidly progressing tumor . 
 a 6-week course of fractionated radiation and concurrent chemotherapy with temodar ( temozolomide capsules ) did not stop tumor progression . 
 intervention : due to the failure of conventional therapies in preventing rapid disease progression , the patient volunteered to undergo a 28-day course of sequentially programmed magnetic field ( spmf ) therapy.resultsimmediate post - therapy mri scan showed a cessation of tumor growth , and follow - up imaging at 6 , 12 , 24 and 36 months revealed a gradual but steady decrease in the size of the tumor . 
 the patient reported an alleviation of clinical symptoms and a subjective improvement in the quality of life at 6 , 12 , 24 and 36 months following spmf therapy.conclusionthe remarkable improvement of this patient suggests that spmf therapy may be a valuable option for anaplastic astrocytoma , especially in recurrent and rapidly progressing tumors . 
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Results
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Introduction
Case Presentation
Discussion
Conclusion