Rich-
If that was a car, it has "cancer"
The rust has propagated well beyond the top tube guides. A consult with a framebuilder and painter is in order, It should be possible to match the paint. You do not show if there is a transfer on the top tube, so that might be a hurdle. It is time to stop the rust.
Top tube cable guides are very problematic, if the builder is game perhaps a replicant in stainless, and silver them on, at least that way when the paint fails it won't oxidize as fast. Or... leave them off? Yes, probably behind that frame's time frame.
Color only on the tube, stopping at the lugs, have a test sprayout to verify all matches well prior to the other work.
John Jorgensen
Palos Verdes Ca USA