Cancer pain cases whose pain had not been treated satisfactorily with routine narcotics were selected from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Each cancer case was diagnosed and confirmed by histopathology or cytopathology. Clinical data and follow-up information were obtained from the hospital records. The study protocol was approved by the local institutional ethics committee, and verbal informed consent was obtained from each patient. Patients with difficulty communicating, a history of adverse response to flubiprofen axetil, or who felt no pain after received other analgesic drugs within 24 hours were excluded.
Dosage and usage of flurbiprofen axetil injection
All selected patients were received 50 mg/5 ml/day of intravenous flurbiprofen axetil injection (50 mg/5 ml, Beijing Tide Pharmaceutical. Co., Ltd, Beijing, China), as flurbiprofen axetil 50 mg added in 100 ml of 0.9% isotonic saline every time through vein within 30 minutes. Dosage and usage of the anaesthetic drugs such as Oxycodone, Tramadol, Duragesic and adjuvant drugs such as diazepam, carbamazepine which being used initially were not changed, or be reduced and ceased after the pain was relieved completely. Other accompanying adjuvant treatments also had been included chemotherapy, radiotherapy, best sustain therapy, bisphosphonate therapy, and etc.
We evaluated cancer pain intensity by Pain Faces Scale criteria , and the three grades as: Mild pain (1–3): Cancer pain could be endurable, and sleep was effected slightly, action was freely, no pain was in the patient's face; Moderate pain (4–6): Cancer pain could be endurable yet, and sleep was effected obviously, action was limited, pain was showed in the patient's face; Severe pain (7–10): Cancer pain could not be endurable, and sleep was effected severely, action was limited hardly, more pain was showed in the patient's face, body's style was passively.
Pain relief was recorded based on four-scale criteria : Complete relief (CR): The pain was disappeared completely, or alleviated significantly, no anesthetic drug must be used; Partial relief (PR): The pain was alleviated significantly than before. The sleep was not disturbed by and large. Patient could live in normal or use a few anesthetic drugs; Minimal relief (MR): The pain was alleviated than before, but it still felt obviously. The sleep was still disturbed by the pain, and the dosage of anesthetic drugs was not reduced significantly than before; No effect (NR): The pain was not alleviated significantly than before, or the dosage of anesthetic drugs were not reduced than before.
CR and PR were regarded as effective response to cancer pain treatment.
Side effects were observed and classified according to the WHO acute and sub-acute toxicity classifying criteria of anticancer drugs . Some symptoms such as swirl, nausea, vomit, abdominal pain, diarrhea, astriction, dysuria, vessel stimulate, etc, were noticed especially after flurbiprofen axetil had being used.