Combination effects oral drops of Holothuria scabra extract and Hylocereus polyrhizus peel on enhancing recovery from post-chemotherapy oral mucositis

Context: One of the therapies in leukemia children is chemotherapy, but it causes side effects of oral mucositis. Oral mucositis is treated in the form of drugs from chemicals or natural ingredients. Holothuria scabra comes from natural collagen ingredients that can help regenerate wound tissue. Hylocereus polyrhizus peel extract potentially serves as a natural antioxidant source and is considered an anti-cancer medication. Aims: To analyze the effectiveness of combined oral drops of H. scabra extract with H. polyrhizus peel having concentrations of 20%, 30%, and 40% in accelerating the healing of post-chemotherapy oral mucositis in Wistar rats analyzed pre-clinically and histopathologically. Methods: The research design was a post-test-only control group. The sample size of 45 rats after being given chemotherapy drugs was divided into 5 groups (positive control group, negative control group, drop application group with concentrations of 20%, 30%, and 40%). After mucositis appeared on the third day after chemotherapy drug administration, rats were given the drug twice a day by 2 drops except for the negative control. Pre-clinical and histopathological observations were made for 3, 7, and 14 days. Data were analyzed using Kruskall Wallis and post hoc using Mann-Whitney. Results: The results of pre-clinical and histopathological observations showed that the combined oral drops of H. scabra extract and H. polyrhizus peel with various concentrations and the positive control had better mucositis healing than the negative control. The results of post-hoc observation on day 7 showed that 20% and 40% concentration drops have the same effectiveness in accelerating the healing of oral mucositis and get better results than the positive control. Conclusions: A 20% concentration extract of H. scabra and H. polyrhizus peel oral drops was chosen as a drug to accelerate the healing of oral mucositis in post-chemotherapy rats.