Extracorporeal shock waves effectively suppressed the proliferation and growth of colorectal cancer

Shock waves are widely used to treat various diseases and are garnering further attention for medical applications. Growing evidence suggests that the application of extracorporeal shock waves (ESV) could substantially inhibit tumor growth. However, the therapeutic efficacy of ESV in colorectal cancer and the underlying mechanisms remain elusive. Using colorectal cancer cell lines HT29 and SW620, we generated xenograft mouse models, and examined the therapeutic effect of a stepwise increase in ESV energy on tumor growth. In vivo , the application of 60 mJ ESV significantly delayed xenograft growth compared with 120 and 240 mJ ESV, with no impact on body weight or hepatic and renal function. Transcriptome analysis revealed that 60 mJ ESV suppressed colorectal cancer cell proliferation and induced cell apoptosis and ferroptosis; these findings were further confirmed by immunohistochemical staining and western blotting. Mechanistically, ESV suppressed cell proliferation and induced cell apoptosis and ferroptosis by activating the p53 signaling pathway, as evidenced in vitro study. In conclusion, we revealed that 60 mJ ESV could substantially inhibit colorectal cancer growth by activating p53 pathway-related proliferation inhibition and cell death. These findings suggest that ESV therapy could be a promising therapeutic strategy for colorectal cancer.