In vitro effects of high energy shock wave alone and combined with anticancer drugs on human bladder cancer cells.

We investigated the in vitro effects of high energy shock wave alone or combined with anticancer drug treatment on an established human bladder cancer cell line, KK-47 cells. Exposure of the cell suspensions to 500-2,500 shock waves, generated with the EDAP lithotriptor LT01, resulted in reduced cell viability with an increasing number of shock doses. DNA flow cytometric analysis revealed a marginal effect on the G2+M and S phases of the cell cycle. When shock wave-treated cells were exposed to mitomycin C, cisplatin, methotrexate or adriamycin, an additive cytotoxic effect was obtained at all shock doses. Adriamycin showed the highest additive effect of the drugs tested. Significant increases in glutamic oxaloacetic transaminase, alkaline phosphatase, creatine phosphokinase and lactate dehydrogenase concentrations in the nutrient medium were observed at over 400 shock doses, reflecting damage to the cell membrane. These data suggest that high energy shock wave may be applicable in combination with some anticancer drugs in the treatment of transitional cell carcinoma.