No Supplements Are Recommended for Choroid Plexus Tumors
There are no supplements that have demonstrated benefit in treating choroid plexus tumors, and the primary treatment remains aggressive surgical resection followed by chemotherapy-based regimens in cases of incomplete resection or carcinoma. The evidence consistently shows that surgical extent of resection is the sole prognostic factor that determines survival, not adjuvant supplementation 1, 2.
Treatment Hierarchy for Choroid Plexus Tumors
Primary Treatment: Surgical Resection
- Gross total resection (GTR) is the only intervention that significantly impacts survival, with patients achieving GTR having an 86% survival rate compared to dismal outcomes with incomplete resection 1.
- GTR can be achieved in 91.7% of cases across all histological grades when performed at experienced centers 3.
- Incomplete resection leads to tumor recurrence in nearly all patients within 2-23 months 1.
Adjuvant Chemotherapy (Not Supplements)
- Etoposide is the most effective chemotherapeutic agent for choroid plexus carcinomas, showing the highest response rate (17/36 patients) and confirmed survival benefit in meta-analysis 4.
- Combination chemotherapy with cyclophosphamide, etoposide, and carboplatin shows statistically significant treatment benefit 4.
- Chemotherapy is indicated for patients younger than 3 years with carcinomas, supplemented by radiotherapy in older children 2.
Why Supplements Are Not Recommended
Antioxidant Supplements Are Contraindicated During Cancer Treatment
- High-dose antioxidant vitamins (C, E, carotenoids) could theoretically protect cancer cells from chemotherapy-induced oxidative damage, potentially reducing treatment efficacy 5.
- The American Cancer Society explicitly advises against exceeding tolerable upper limits of antioxidant vitamins during active cancer treatment 5.
- This concern is particularly relevant given that choroid plexus carcinoma patients often receive etoposide-based chemotherapy, which relies on oxidative mechanisms 4.
Folate-Related Supplements Require Caution
- Folic acid supplementation can be counterproductive if the patient receives methotrexate-based regimens, as methotrexate acts by interfering with folic acid metabolism 5.
- While methotrexate is not the primary agent for choroid plexus tumors, this illustrates the potential for supplement-chemotherapy interactions 4.
Acceptable Nutritional Support (Not Treatment)
Standard Multivitamins Only
- A standard multivitamin containing approximately 100% of the Daily Value is acceptable if dietary intake is inadequate during treatment 5.
- This provides physiological doses (not pharmacological doses) to prevent deficiency without risking interference with chemotherapy 5.
Critical Communication Requirement
- 31-68% of cancer patients using supplements fail to disclose this to their physicians, creating dangerous potential for drug interactions 5.
- All supplement use must be disclosed to the oncology team before initiating chemotherapy 5.
Clinical Algorithm for Choroid Plexus Tumor Management
Pursue maximal safe surgical resection as the definitive treatment—this is the only factor that determines survival 1, 3.
For incomplete resection or carcinoma histology: Initiate etoposide-based chemotherapy (with cyclophosphamide and carboplatin) 4.
Avoid high-dose supplements (>100% Daily Value) during active chemotherapy, particularly antioxidants 5.
Consider standard multivitamin (100% Daily Value) only if dietary intake is compromised during treatment 5.
Monitor for CSF disturbances: 25% of patients require ventricular or subdural shunting even after resection 3.
Common Pitfalls to Avoid
- Do not delay surgery in favor of any supplement-based approach—surgical delay worsens prognosis 1.
- Do not use "second-look" surgery as a planned strategy; aim for complete resection at initial operation 1.
- Do not assume hydrocephalus will resolve with tumor removal alone—9 patients in one series required ventriculoperitoneal shunting post-resection 2.
- Do not withhold chemotherapy in young children due to concerns about long-term effects—the 5-year survival for carcinomas is only 40% even with aggressive treatment 2.