Ischemia and loss of ATP in tumours following treatment with focused high energy shock waves.

High energy shock waves (HESW) have been reported to be cytotoxic to tumour cells in vitro and in vivo. For that reason they are evaluated as a new modality for cancer treatment. In the present study we have quantified the effect of treatment with multifocal HESW on tumour blood flow and energy status. Blood flow and adenosine triphosphate (ATP) concentration were investigated simultaneously in tumour and adjacent tissue of six treated and six untreated amelanotic hamster melanomas (A-Mel-3) at 3, 12 or 24 h after multifocal application of HESW. 14C-iodoantipyrine autoradiography for blood flow measurements and quantitative ATP imaging bioluminescence were employed. Following treatment, tumour blood flow and ATP concentration were significantly reduced, as compared to control, over the entire period of observation. Three hours after HESW, blood flow and ATP concentration were at the background level. In adjacent tissue, blood flow and ATP concentration were distinctly diminished. We therefore conclude that multifocal HESW induce a breakdown of tumour-, and adjacent tissue perfusion which is accompanied by a significant decrease of intracellular ATP concentration.