...
RewriteRule lib/exe/fetch\.php - [E=X_CACHE_HEADER]
RewriteRule ^_media/(.*)              lib/exe/fetch.php?media=$1  [QSA,L]
RewriteRule ^_detail/(.*)             lib/exe/detail.php?media=$1  [QSA,L]
RewriteRule ^_export/([^/]+)/(.*)     doku.php?do=export_$1&id=$2  [QSA,L]
RewriteRule ^$                        doku.php  [L]
RewriteCond %{REQUEST_FILENAME}       !-f
RewriteCond %{REQUEST_FILENAME}       !-d
RewriteRule (.*)                      doku.php?id=$1  [QSA,L]
RewriteRule ^index.php$               doku.php

Header always set Pragma cache env=X_CACHE_HEADER
...