6. Conclusion

Sonotherapy appears to be a new therapeutic treatment modality with great potential, particularly in comparison with photodynamic therapy, as it allows access to deep pathological territories (4 to 10 cm) in a minimally invasive way. While numerous preclinical studies have been published, the clinical efficacy of sonotherapy has yet to be demonstrated, probably requiring a more in-depth understanding of the different underlying mechanisms of action of sonotherapy, depending on the different classes of sonosensitizers used.

These mechanisms include induction of cellular stress via mechanical shearing of the cell membrane or moderate hyperthermal effects, and ROS-mediated cytotoxicity from pyrolysis or activation of sonosensitizers by cavitation-induced sonoluminescence emission. The latter appears to be the predominant mechanism of action.

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