TREATMENT OF HUMAN RENAL-CELL CARCINOMA WITH HIGH-ENERGY SHOCK-WAVES - A NEW IN-VIVO IN-VITRO MODEL

The effects of high-energy shock waves (HESW) on the human renal cell carcinoma were examined. The kidneys were available from 32 patients t reated by radical nephrectomy due to renal cell carcinoma. Immediately after nephrectomy the kidneys were perfused with cold HTK solution an d stored for a maximum of 4 h in hypothermia at 8 degrees C. The tumor s were treated with 4,000 shocks (65 mPa = 0.6 mJ/mm(2)) in an electro magnetic lithotriptor (Siemens Co., Erlangen, Germany). Microscopic an d immunohistological examinations of the tumors were performed after t reatment, and cell proliferation rates of treated and untreated specim ens were analyzed by cell cultures in 10 cases. HESW induce severe mic roscopic damage in the tumor tissue as complete rupture of the vessel walls and destruction of the tubular-formed tumor masses in the focal area. Immunohistochemistry shows intact immune reactive endothelial ce lls by factor 8-associated antibodies until the border to histological damage. Around this region a zone of negative antibody reaction again st collagen type 4 is found. In cell cultures the proliferation rates of treated specimens were significantly lower compared to untreated. T he human renal cell carcinoma seems to be susceptible for treatment wi th shock waves. HESW induce direct damage of tumor cells and vascular damage in the tumor which may be the primary cause of tumor necrosis.