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B.), Institut National du Cancer Cortico-Medullo Tumeurs Endocrines, Cochin Hospital, Institut Cochin, Institut National de la Santé et de la Recherche Médicale Unité 1016, René Descartes University, Paris, F-75006 France Division of Endocrinology (F.

Urinary steroid metabolite excretion was profiled by gas chromatography/mass spectrometry in comparison with healthy controls (n = 88).

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B.), Institut National du Cancer Cortico-Medullo Tumeurs Endocrines, Cochin Hospital, Institut Cochin, Institut National de la Santé et de la Recherche Médicale Unité 1016, René Descartes University, Paris, F-75006 France Department of Endocrinology (R. Mitotane is considered an adrenolytic substance, but there is limited information on distinct effects on steroidogenesis.

B.), Institut National du Cancer Cortico-Medullo Tumeurs Endocrines, Cochin Hospital, Institut Cochin, Institut National de la Santé et de la Recherche Médicale Unité 1016, René Descartes University, Paris, F-75006 France Department of Endocrinology (R. M.), Veneto Institute of Oncology Instituto di Ricovero e Cura a Carattere Scientifico and Department of Medical and Surgical Sciences, University of Padova, I-35100 Padova, Italy Address all correspondence and requests for reprints to: Prof Wiebke Arlt MD DSc FRCP FMed Sci, Centre for Endocrinology, Diabetes and Metabolism, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, B15 2TT, United Kingdom, Tel. Mitotane [1-(2-chlorophenyl)-1-(4-chlorophenyl)-2,2-dichloroethane] is the first-line treatment for metastatic adrenocortical carcinoma (ACC) and is also regularly used in the adjuvant setting after presumed complete removal of the primary tumor.

Many studies have been conducted with regard to free radicals, oxidative stress and antioxidant activity of food, giving antioxidants a prominent beneficial role, but, recently many authors have questioned their importance, whilst trying to understand the mechanisms behind oxidative stress.

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The detection of antioxidant activity as well as specific antioxidant compounds can be carried out with a large number of different assays, all of them with advantages and disadvantages.

The controversy around antioxidant in vivo benefits has become intense in the past few decades and the present review tries to shed some light on research on antioxidants (natural and synthetic) and prooxidants, showing the potential benefits and adverse effects of these opposing events, as well as their mechanisms of action and detection methodologies.

Adrenocortical carcinoma (ACC) is a rare cancer, with an incidence of one to two cases per million per year and a poor prognosis, mostly due to a high risk of recurrence and limited therapeutic options (1).

Mitotane [1-(2-chlorophenyl)-1-(4-chlorophenyl)-2,2-dichloroethane (o,p′-DDD)], an analog of the insecticide dichlorodiphenyltrichloroethane (DDT), has been used in the treatment of ACC since 1959 (2).

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