I bought an 07 4R 2 years ago from Ohio. It's frame had a lot of rust on it but it did not look as bad as yours. There were no obvious holes or defects and the skid plates were still (mostly) intact.
At first, I tried to sandblast off the rust. This was a complete waste of time and money. Then I started spraying it with rust dissolver (like:
this). The rust dissolver worked extremely well as long as I could spray it heavily and let it soak in for several hours, repeatedly spraying as it soaked in. I probably went through two gallons of the stuff. I also tried my best to spray on the inside of the frame. I should mention I was living in Arizona and I just parked the truck in the desert beside my house and had no issue with chemicals/water dripping into the sand.
I would then wash it off really well with a pressure washer and let it dry, which only took a few hours in the AZ sun. I probably repeated this 2-3 times on the entire frame until I really didn't see much rust leftover. It worked well.
Rather soon after pressure washing and allowing it to dry (within a day or two), I would then spray it really well with
rust reformer. This worked well also and I probably used 12 cans. I then sprayed parts I wanted black with
chasis paint.
Overall, it worked extremely well and I see no recurrence of rust 2 years out. Will try to dig us some before/after pics. Your rust looks significantly worse so I don't know if this process would work for you. Also, my truck has been in Arizona since doing this, so who knows what would have happened elsewhere. I just relocated to the NE, so check back with me in 6 months and I'll let you know how it has held up.