***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a clinical double-blind study , the analgesic efficacy and the side-effects of nimesulide ( Aulin , CAS 51803 - 78 - 2 ) and naproxen administered to 68 patients affected by advanced cancer pain were compared . Patients were treated with non-steroidal anti-inflammatory drugs according to the first step of the pharmacological analgesic scale of the WHO . The dose administered was 200 mg b.i.d . ( every 12 h ) for nimesulide and 500 mg b.i.d . ( every 12 h ) for naproxen . From this study the analgesic effect and the tolerability of the two drugs appeared to be similar . Both drugs result ed to be effective with a low incidence of adverse events that may be related to their use The analgesic efficacy of ketorolac tromethamine was compared to placebo in 126 patients suffering moderate or severe chronic pain due to cancer in a double-blind parallel r and omized study . Ketorolac was administered intramuscularly in doses of 10 , 30 or 90 mg . Pain intensity and pain relief were assessed for 6 hours by scoring st and ard verbal scales and an overall assessment of the medication was given by the patients and the observer on completion of the study . Each dose of ketorolac was statistically superior to placebo for the sum of pain intensity difference ( SPID ) but no difference was seen between the three ketorolac regimens . When the ketorolac groups are combined , there was a significantly better pain relief as compared to placebo . The global evaluation scores were also statistically superior in the ketorolac groups combined than in the placebo group . A total of 15 patients reported minor adverse events , 10 being after ketorolac doses . This study shows that single intramuscular doses of ketorolac of 10 mg and above are effective in the relief of cancer pain , and are associated with a low incidence of side-effects Benzydamine hydrochloride rinse reduced pain associated with radiation mucositis when it was used during the course of radiation therapy . Fewer patients using benzydamine rinse required systemic analgesics . All patients using benzydamine tolerated the rinse well and continued with regular rinsing throughout the course of radiation therapy . Benzydamine hydrochloride is currently undergoing clinical trials in the United States for application for approval from the Food and Drug Administration & NA ; A prospect i ve double‐blind r and omized trial was conducted on 184 cancer patients with moderate to severe chronic pain to evaluate the analgesic efficacy and tolerability of diclofenac alone ( 50 mg q.i.d . ) or in combination with a weak opioid ( codeine 40 mg q.i.d . ) , or with an anti‐depressant ( imipramine , 10 or 25 mg t.i.d . ) . All demographic and clinical characteristics including cancer type , presence of bone metastases , baseline pain severity , neuropathic and nociceptive pain , and depressive state , were well balanced between the three treatment groups . The main analysis of the study was on the VAS scores at visit 2 ( day 4 ) . The mean VAS values for both associations imipramine plus diclofenac and codeine plus diclofenac were similar to the association placebo plus diclofenac . Patients on imipramine plus diclofenac and on placebo plus diclofenac were withdrawn mainly for inadequate efficacy , while patients on codeine plus diclofenac discontinued equally for inadequate efficacy or adverse events . In conclusion , in a short‐term evaluation the addition of a tricyclic anti‐depressant or a weak opioid to diclofenac did not provide further analgesia with respect to diclofenac administration alone In a controlled double blind study of  analgesics for the pain of gastrointestinal cancer ,  aspirin ( 650 mg ) was significantly more effective than placebo and superior to orally used codeine sulfate ( 60 mg ) . The effectiveness of aspirin  was not specific for carcinoma of the pancreas , however , because the same pattern of pain relief was found in colonic carcinoma & NA ;  Pain intensity is frequently measured on an 11‐point pain intensity numerical rating scale ( PI‐NRS ) , where 0=no pain and 10=worst possible pain . However , it is difficult to interpret the clinical importance of changes from baseline on this scale ( such as a 1‐ or 2‐point change ) . To date , there are no data driven estimates for clinical ly important differences in pain intensity scales used for chronic pain studies . We have estimated a clinical ly important difference on this scale by relating it to global assessment s of change in multiple studies of chronic pain . Data on 2724 subjects from 10 recently completed placebo‐controlled clinical trials of pregabalin in diabetic neuropathy , postherpetic neuralgia , chronic low back pain , fibromyalgia , and osteoarthritis were used . The studies had similar design s and measurement instruments , including the PI‐NRS , collected in a daily diary , and the st and ard seven‐point patient global impression of change ( PGIC ) , collected at the endpoint . The changes in the PI‐NRS from baseline to the endpoint were compared to the PGIC for each subject . Categories of ‘ much improved ’ and ‘ very much improved ’ were used as determinants of a clinical ly important difference and the relationship to the PI‐NRS was explored using graphs , box plots , and sensitivity/specificity analyses . A consistent relationship between the change in PI‐NRS and the PGIC was demonstrated regardless of study , disease type , age , sex , study result , or treatment group . On average , a reduction of approximately two points or a reduction of approximately 30 % in the PI‐NRS represented a clinical ly important difference . The relationship between percent change and the PGIC was also consistent regardless of baseline pain , while higher baseline scores required larger raw changes to represent a clinical ly important difference . The application of these results to future studies may provide a st and ard definition of clinical ly important improvement in clinical trials of chronic pain therapies . Use of a st and ard outcome across chronic pain studies would greatly enhance the comparability , validity , and clinical applicability of these studies Summary The analgesic efficacy and tolerability of nimesulide and naproxen were compared in 68 patients with advanced cancer who needed to be treated with nonsteroidal anti-inflammatory drugs according to the first step of the pharmacological analgesic scale of the WHO . Patients received either nimesulide 200 mg or naproxen 500 mg twice daily . The analgesic efficacy and tolerability of the 2 drugs appeared to be similar . Both drugs were effective and were associated with a low incidence of adverse reactions In a single-dose , a double-blind crossover study in 40 patients with chronic pain due to advanced cancer , zomepirac sodium ( Zomax ) , a new , single-entity , non-narcotic analgesic , was compared to oxycodone with APC ( Percodan ) and placebo . Both a verbal and a curvilinear visual analog scale were used in the study , and the results obtained were comparable . Zomepirac sodium , 100 mg , provided analgesia equal to oxycodone with APC in all assessment s of pain intensity and pain relief . The analgesic activity of zomepirac sodium was apparent by 1 hour , reached a peak between 3 and 4 hours after administration , and lasted at least 6 hours . Zomepirac sodium , 100 mg , appears to be an acceptable alternative to narcotic combinations such as oxycodone with APC in the management of moderate to severe cancer pain . The visual analog scale presented appears to be useful in the evaluation of analgesic efficacy and appears to be acceptable as an alternative to the more conventional verbal scale In a double-blind , r and omised and parallel clinical trial , two oral doses of dipyrone ( 1 and 2 g ) administered every 8 h were compared with 10 mg of oral morphine given every 4 h for the relief of  chronic cancer pain .  A total of 121 patients with cancer pain without gastric involvement participated in a 7-day treatment course and were allocated to receive either dipyrone 1 g ( n = 41 ) , dipyrone 2 g ( n = 38 ) or morphine ( n = 42 ) . Drug efficacy was analysed according to the degree of pain relief using a 100-mm visual analogue scale , and the number of patients who decided to increase the dose of the analgesic drug on day 4 . The analgesic effect of dipyrone , 2 g every 8 h , was similar to that of morphine . The efficacy of both schedules was significantly greater than that of dipyrone , 1 g every 8 h. Dipyrone at either 1 or 2 g doses tended to be better tolerated than morphine , although the differences were not statistically significant With a subjective response technique the analgetic activity of two non-steroidal anti-inflammatory agents which greatly differ in kinetics is compared . The double-blind cross-over trial was carried out in 18 patients of both sexes suffering from pain due to malignant tumours who received single doses of 200 mg indoprofen and 250 mg naproxen p.o . Both compounds were efficacious and there was no difference in the duration of their activity in spite of the great difference between their half-lives STUDY OBJECTIVE To compare the analgesic efficacy and safety of two single doses of ketorolac with diclofenac in acute cancer pain . DESIGN Double-blind , r and omized , clinical study . SETTING Hospital-based clinical research center . SUBJECTS One hundred eighty patients suffering acute , moderate , or severe cancer pain . INTERVENTIONS A single intramuscular injection of ketorolac 10 or 30 mg or diclofenac 75 mg . MEASUREMENTS AND MAIN RESULTS Pain intensity was assessed 30 minutes and 1 , 2 , 3 , 4 , 5 , and 6 hours after injection or until rescue drug administration . In approximately 70 % of patients all treatments provided prompt sustained pain relief throughout the 6-hour observation period . There were no statistically significant differences in any of the analyzed efficacy measures among the three groups . CONCLUSION Intramuscular ketorolac 10 mg is adequate to relieve cancer pain , and is equivalent to ketorolac 30 mg and to diclofenac 75 mg OBJECTIVE To compare the effectiveness of intravenous patient-controlled ( i.v.-PCA ) ketorolac to i.v.-PCA morphine in the treatment of postoperative pain in cancer patients . DESIGN In a double-blind , prospect i ve , r and omized trial , patients received either morphine  in 1 mg/ml concentration or ketorolac 5 mg/ml for postoperative pain control . On arrival to the postanesthesia care unit ( PACU ) , the patients received 2 ml of medication every 5 min , until satisfactory analgesia was achieved . If pain persisted after 20 ml of study drug had been administered , 0.1 mg/kg morphine was given i.m . On discharge from the PACU , the patients were placed on an i.v.-PCA pump . All patients received a basal infusion of 1 ml/h with a 1-ml on-dem and bolus and a lockout interval of 10 min . Patients were offered 0.1 mg/kg morphine IM every 6 h , which they could refuse . SETTING University Cancer Center . PATIENTS Seventy patients scheduled for abdominal or truncal cancer operations . MAIN OUTCOME MEASURES Visual analog pain scores ( VAPS ) and Visual analog sedation scores ( VASS ) were used to measure the quality of pain control achieved either with ketorolac or morphine . The incidence of side effects was documented . RESULTS The VAPS were comparable between the groups . Patients in the ketorolac group requested more supplemental i.m . morphine . However , the total morphine dose and incidence of side effects was significantly higher in patients receiving i.v.-PCA morphine . CONCLUSIONS These results indicate that ketorolac supplemented with small doses of morphine is associated with a lower incidence of nausea , vomiting , and pruritus compared to morphine alone . This combination should be considered where immunosuppression from operation and administration of morphine is undesirable The efficacy of diflunisal in  cancer pain  was evaluated and compared with dipyrone . Diflunisal was given at the dosage of 500 mg perorally twice a day , and dipyrone was given at the dosage of 500 mg perorally three times a day . Duration of each treatment was 7 days ; after a 12-hour wash-out period , patients were given the other drug for another 7 days . A total of 50 patients were enrolled in the study .  Pain intensity was assessed by 10-point visual analog scale ( VAS ) .  Patients who had a VAS score higher than 5 were included . A total of 47 patients were evaluable . Initial VAS score was a mean of 8.57+/-1.33 . Diflunisal reduced the pain score by a mean of 4.65+/-3.10 , whereas dipyrone reduced the pain score by a mean of 3.25 < or = 2.85 ( p < 0.001 ) . Patients were also analyzed in three subgroups according to the presence of nonmetastatic , metastatic , and bone metastatic diseases . In each of these subgroups , diflunisal reduced the pain score more than dipyrone ; however , the difference was statistically significant only in patients who had bone metastasis . Adverse reactions were rare and acceptable with both drugs . Diflusinal is superior to dipyrone at this dosage and schedule in the treatment of moderate to severe cancer pain 
    Output:
    
The short duration of studies undermines generalization of their findings on efficacy and safety of NSAIDs for cancer pain